Effect of pregestational diabetes mellitus on fetal cardiac function and structure.
OBJECTIVE
Fetuses of diabetic pregnancy experience cardiomyopathy, the intracardiac cause of which is understood poorly. The aim of this study was to assess the interrelation between cardiac functional and structural changes in fetuses of mothers with pregestational diabetes mellitus.


METHODS
Twenty-six mothers with pregestational diabetes mellitus were recruited prospectively to have a fetal echocardiogram at 13, 20, and 36 weeks of gestation to assess cardiac function and structure. For comparison, 30 healthy control subjects were recruited at each gestational age.


RESULTS
In the first trimester, there was evidence of poorer fetal cardiac diastolic function among the diabetic cohort (lower left early/atrial ratio, longer isovolumetric relaxation time and higher left myocardial performance index; P < .05). In the third trimester, the fetal interventricular septum and the right ventricular free wall were thicker in the diabetic cohort (P < .05).


CONCLUSIONS
In fetuses of pregestational diabetic pregnancy, sonographic evidence of altered cardiac function is evident before ultrasound evidence of cardiac structural changes. This suggests that altered cardiac function may precede cardiac structural changes in fetuses of pregestational diabetic pregnancy.
Russell
Noirin E
NE
Department of Obstetrics and Gynaecology, National Maternity Hospital, Dublin, Ireland.
Foley
Michael
M
Kinsley
Brendan T
BT
Firth
Richard G
RG
Coffey
Mary
M
McAuliffe
Fionnuala M
FM
D000328:Adult; D003922:Diabetes Mellitus, Type 1 / Q000503:physiopathology*; D015150:Echocardiography, Doppler; D005260:Female; D005318:Fetal Heart / Q000000981:diagnostic imaging / Q000473:pathology* / Q000502:physiology*; D005865:Gestational Age; D006352:Heart Ventricles / Q000196:embryology / Q000473:pathology; D006801:Humans; D009200:Myocardial Contraction; D011247:Pregnancy; D011261:Pregnancy Trimester, First / Q000502:physiology; D011262:Pregnancy Trimester, Second / Q000502:physiology; D011263:Pregnancy Trimester, Third / Q000502:physiology; D011254:Pregnancy in Diabetics / Q000503:physiopathology*; D011446:Prospective Studies; D016216:Ultrasonography, Prenatal; D016276:Ventricular Function