TY - JOUR
T1 - Cardiac function in gestational diabetes mellitus
T2 - A longitudinal study from fetal life to infancy
AU - Aguilera, J.
AU - Semmler, J.
AU - Anzoategui, S.
AU - Zhang, H.
AU - Nicolaides, K. H.
AU - Charakida, M.
N1 - Funding Information:
This study was funded by a grant from the Fetal Medicine Foundation (Charity No: 1037116).
Publisher Copyright:
© 2020 Royal College of Obstetricians and Gynaecologists
Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2021/1
Y1 - 2021/1
N2 - Objective: To determine whether cardiac functional and structural changes in fetuses of mothers with gestational diabetes mellitus (GDM) persist in the offspring beyond the neonatal period. Design: Longitudinal study. Setting: Fetal Medicine Unit in a UK teaching hospital. Methods: 73 women with GDM and 73 women with uncomplicated pregnancy were recruited and fetal cardiac scans were performed at 35–36 weeks' gestation. Repeat echocardiogram was performed in their offspring during infancy. Main outcome measures: Fetal and infant cardiac functional and structural changes. Results: Fetuses of mothers with GDM, compared with controls, had more globular right ventricles (sphericity index 0.7, interquartile range [IQR] 0.6/0.7 versus 0.6, IQR 0.5/0.6, P < 0.001) and reduced right global longitudinal systolic strain (−16.4, IQR −18.9/−15.3 versus −18.5, IQR −20.6/−16.8, P = 0.001) and left global longitudinal systolic strain (−20.1, IQR −22.5/−16.9 versus −21.3, IQR −23.5/−19.5), P = 0.021). In the GDM group, compared with controls, in infancy there was higher left ventricular E/e’ (8.7, IQR 7.3/9.7 versus 7.9 IQR, 6.8/8.9 P = 0.011) and lower left ventricular global longitudinal systolic strain (−21.0, IQR −22.5/−19.4 versus −22.3, IQR −23.5/−20.7, P = 0.001) and tricuspid annular plane systolic excursion (13.8, IQR 12.7/16.1 versus 15.2, IQR 13.8/16.8, P = 0.003). These differences remained following multivariable analysis. Conclusion: Gestational diabetes mellitus is associated with alterations in fetal cardiac function and structure compared with controls and persistent cardiac changes in infancy. Tweetable abstract: Gestational diabetes mellitus, even when well controlled, is associated with fetal cardiac changes and these persist in infancy.
AB - Objective: To determine whether cardiac functional and structural changes in fetuses of mothers with gestational diabetes mellitus (GDM) persist in the offspring beyond the neonatal period. Design: Longitudinal study. Setting: Fetal Medicine Unit in a UK teaching hospital. Methods: 73 women with GDM and 73 women with uncomplicated pregnancy were recruited and fetal cardiac scans were performed at 35–36 weeks' gestation. Repeat echocardiogram was performed in their offspring during infancy. Main outcome measures: Fetal and infant cardiac functional and structural changes. Results: Fetuses of mothers with GDM, compared with controls, had more globular right ventricles (sphericity index 0.7, interquartile range [IQR] 0.6/0.7 versus 0.6, IQR 0.5/0.6, P < 0.001) and reduced right global longitudinal systolic strain (−16.4, IQR −18.9/−15.3 versus −18.5, IQR −20.6/−16.8, P = 0.001) and left global longitudinal systolic strain (−20.1, IQR −22.5/−16.9 versus −21.3, IQR −23.5/−19.5), P = 0.021). In the GDM group, compared with controls, in infancy there was higher left ventricular E/e’ (8.7, IQR 7.3/9.7 versus 7.9 IQR, 6.8/8.9 P = 0.011) and lower left ventricular global longitudinal systolic strain (−21.0, IQR −22.5/−19.4 versus −22.3, IQR −23.5/−20.7, P = 0.001) and tricuspid annular plane systolic excursion (13.8, IQR 12.7/16.1 versus 15.2, IQR 13.8/16.8, P = 0.003). These differences remained following multivariable analysis. Conclusion: Gestational diabetes mellitus is associated with alterations in fetal cardiac function and structure compared with controls and persistent cardiac changes in infancy. Tweetable abstract: Gestational diabetes mellitus, even when well controlled, is associated with fetal cardiac changes and these persist in infancy.
KW - Cardiac
KW - diabetes
KW - fetal
KW - offspring
UR - http://www.scopus.com/inward/record.url?scp=85089823485&partnerID=8YFLogxK
U2 - 10.1111/1471-0528.16434
DO - 10.1111/1471-0528.16434
M3 - Article
C2 - 32725766
AN - SCOPUS:85089823485
SN - 1470-0328
VL - 128
SP - 272
EP - 279
JO - BJOG: An International Journal of Obstetrics and Gynaecology
JF - BJOG: An International Journal of Obstetrics and Gynaecology
IS - 2
ER -