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.
