Cardiac Function and Structure in Fetuses of Gestational and Pre-Gestational Mothers Suffering Diabetes

Abstract

Background: The prevalence of maternal hyperglycemic disorders during pregnancy is increasing due to the obesity epidemic and increasing age of the pregnant mothers. This study aimed to assess the cardiac function and structure in fetuses of gestational and pre-gestational mothers suffering diabetes compared to those of healthy mothers using fetal echocardiography. Methods: This cross-sectional study included a total number of 60 pregnant women, they were classified into three equal groups; group I included 20 pregnant women with pre-gestational diabetes mellitus (GDM), group II included 20 pregnant women with GDM, and group III included 20 healthy pregnant women as the control group. These women were subjected to complete history taking, laboratory investigations, and fetal echocardiography evaluation for cardiac function using M mode, 2 dimensional, and pulsed wave Doppler. Results: Interventricular septum (IVS) as well as left ventricular (LV) wall thickness were significantly increased (p < 0.05) in mothers suffering diabetes compared to the healthy control group. Diabetes decreased LV diastolic function but did not affect LV systolic function. IVS thickness has a significant positive correlation (p < 0.05) with all indices of DM such as HbA1c, fasting blood glucose, and 2 hours postprandial glucose level. While mitral E-wave/A-wave ratio had a significant negative correlation (p < 0.05) with duration of DM. Conclusions: IVS thickness is the most affected structures in fetal heart of mothers suffering diabetes. Moreover, LV diastolic function was affected in such fetuses unlike the systolic function. Fetal echocardiography in mothers suffering diabetes is highly important, not only to diagnose structural abnormalities but also for evaluation of cardiac function of the fetuses.