Cardiac Function in Offspring of Women With Gestational Diabetes Mellitus

Sarfaroj Khan 

August 06, 2020

Takeaway

  • Gestational diabetes mellitus (GDM) is associated with foetal cardiac function and structure changes, and these persist in the offspring beyond the neonatal period.

  • These associations are not modified by maternal diabetic treatment.

Why this matters

  • Findings suggest that maternal GDM may have prolonged adverse influence on the cardiovascular health of the offspring.

Study design

  • This prospective longitudinal study included 73 women with singleton pregnancies with GDM and 73 women with uncomplicated pregnancies (control group).

  • Foetal ultrasound scans were performed at 35-36 weeks’ gestation; repeat echocardiogram was performed in their offspring during infancy.

  • Funding: Fetal Medicine Foundation.

Key results

  • Compared with the control group, the foetuses of mothers with GDM had:

    • more globular right ventricles (sphericity index: 0.7 vs 0.6; P < .001); and

    • reduced right (−16.4% vs −18.5%; P =.001) and left (−20.1% vs −21.3%; P = .021) ventricular global longitudinal systolic strain.

  • Diastolic functional indices did not differ between both groups.

  • In infancy, GDM vs control group had:

    • higher left ventricular E/e’ (8.7 vs 7.9; P = .011); and

    • lower left ventricular global longitudinal systolic strain (−21.0% vs −22.3%; P = .001) and tricuspid annular plane systolic excursion (13.8 mm vs 15.2 mm; P = .003).

  • No significant interaction was noted between GDM and time interval from foetal cardiac assessment.

  • No significant difference was observed in postnatal cardiac functional and structural indices within the GDM group according to diabetes treatment in pregnancy.

Limitations

  • Foetal speckle tracking analysis was performed using one analysis platform.

  • Postnatal cardiac assessment was performed 4 months earlier for the GDM than the control group.

BJOG. Published online July 29, 2020. Abstract

This article originally appeared on Univadis, part of the Medscape Professional Network.

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