Comparison of Fetal Cardiac Function between Pregnancies with Diabetes Mellitus and Normal Controls

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Podjanee Phadungkiatwattana
Lunthaporn Puttanavijarn

Abstract

Objectives: The purpose of this study was to compare fetal cardiac function (systolic, diastolic and global) in patients with maternal diabetes mellitus during 35-37 weeks of gestation and to evaluate the association between cardiac function and adverse perinatal outcomes.
Materials and Methods: In this prospective observational cross-sectional study, 138 pregnant women with diabetes and 149 healthy pregnant women underwent fetal echocardiography to evaluate fetal cardiac function. The perinatal outcomes were evaluated after delivery.
Results: This study found that the mean modified myocardial performance index (mod-MPI) was significantly raised in fetuses of diabetic mothers (0.53 ± 0.06 vs. 0.49 ± 0.05, p < 0.001) while the mean E/A ratio ratio and cardiac output (CO) were similar in the diabetes and control groups. A subgroup analysis showed that mitral E/A and tricuspid E/A ratios, Mod-MPI, right, left, and combined CO were similar in women with gestational diabetes (GDM) with diet control and those with GDM or pre-gestational diabetes (PDM) with insulin usage. The neonatal outcomes (Apgar score at 1 min, Apgar score at 5 min, Apgar score ≤ 6 at 5-min, cesarean delivery due to fetal non-reassuring, neonatal intensive care unit admission, stillbirth, and perinatal death) were similar in the two groups. No correlation was observed between the fetal cardiac function and adverse perinatal outcomes.
Conclusion: Mod-MPI in the diabetic group was the only fetal cardiac function that was significantly higher than in the healthy pregnant women. No significant correlation was observed between fetal cardiac function and adverse perinatal outcomes.

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References

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