title: Gestational diabetes alters the fetal heart rate variability during an oral glucose tolerance test: a fetal magnetocardiography study.
abstract: OBJECTIVE
  Gestational diabetes mellitus (GDM) potentially harms the child before birth. We previously found GDM to be associated with developmental changes in the central nervous system. We now hypothesise that GDM may also impact on the fetal autonomic nervous system under metabolic stress like an oral glucose tolerance test (OGTT).
  
  
  METHODS
  We measured heart rate variability (HRV) of mothers and fetuses during a three-point OGTT using fetal magnetocardiography (fMCG).
  
  
  METHODS
  Measurements were performed in the fMEG Centre in Tübingen.
  
  
  METHODS
  After exclusion of 23 participants, 13 pregnant women with GDM and 36 pregnant women with normal glucose tolerance were examined.
  
  
  METHODS
  All women underwent the same examination setting with OGTT during which fMCG was recorded three times.
  
  
  METHODS
  Parameters of heart rate variability were measured.
  
  
  RESULTS
  Compared with mothers with normal glucose regulation, mothers with GDM showed increased heart rate but no significant differences of maternal HRV. In contrast, HRV in fetuses of mothers with GDM differed from those in the metabolically healthy group regarding standard deviation normal to normal beat (SDNN) (P = 0.012), low-frequency band (P = 0.008) and high-frequency band (P = 0.031). These HRV parameters exhibit a decrease only in GDM fetuses during the second hour of the OGTT.
  
  
  CONCLUSIONS
  These results show an altered response of the fetal autonomic nervous system to metabolic stress in GDM-complicated pregnancies. Hence, disturbances in maternal glucose metabolism might not only impact on the central nervous system of the fetus but may also affect the fetal autonomic nervous system.
  
  
  CONCLUSIONS
  Metabolic stress reveals a different response of fetal autonomic nervous system in GDM-complicated pregnancies.
authors.affiliation: Division of Endocrinology, Diabetology, Angiology, Nephrology and Clinical Chemistry, Department of Internal Medicine, University Hospital, Eberhard Karls University, Tübingen, Germany.|Institute for Diabetes Research and Metabolic Diseases, Helmholtz Centre Munich, University of Tübingen, Tübingen, Germany.|German Centre for Diabetes Research (DZD), Tübingen, Germany.
authors.forename: E
authors.initials: E
authors.lastname: Fehlert
authors.affiliation: Division of Endocrinology, Diabetology, Angiology, Nephrology and Clinical Chemistry, Department of Internal Medicine, University Hospital, Eberhard Karls University, Tübingen, Germany.
authors.forename: K
authors.initials: K
authors.lastname: Willmann
authors.affiliation: Division of Endocrinology, Diabetology, Angiology, Nephrology and Clinical Chemistry, Department of Internal Medicine, University Hospital, Eberhard Karls University, Tübingen, Germany.|Institute for Diabetes Research and Metabolic Diseases, Helmholtz Centre Munich, University of Tübingen, Tübingen, Germany.|German Centre for Diabetes Research (DZD), Tübingen, Germany.
authors.forename: L
authors.initials: L
authors.lastname: Fritsche
authors.affiliation: Division of Endocrinology, Diabetology, Angiology, Nephrology and Clinical Chemistry, Department of Internal Medicine, University Hospital, Eberhard Karls University, Tübingen, Germany.|Institute for Diabetes Research and Metabolic Diseases, Helmholtz Centre Munich, University of Tübingen, Tübingen, Germany.|German Centre for Diabetes Research (DZD), Tübingen, Germany.
authors.forename: K
authors.initials: K
authors.lastname: Linder
authors.affiliation: Division of Endocrinology, Diabetology, Angiology, Nephrology and Clinical Chemistry, Department of Internal Medicine, University Hospital, Eberhard Karls University, Tübingen, Germany.
authors.forename: H
authors.initials: H
authors.lastname: Mat-Husin
authors.affiliation: Institute for Diabetes Research and Metabolic Diseases, Helmholtz Centre Munich, University of Tübingen, Tübingen, Germany.|German Centre for Diabetes Research (DZD), Tübingen, Germany.
authors.forename: F
authors.initials: F
authors.lastname: Schleger
authors.affiliation: Department of Obstetrics and Gynaecology, University Hospital, Eberhard Karls University, Tübingen, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Weiss
authors.affiliation: Department of Obstetrics and Gynaecology, University Hospital, Eberhard Karls University, Tübingen, Germany.
authors.forename: I
authors.initials: I
authors.lastname: Kiefer-Schmidt
authors.affiliation: Department of Obstetrics and Gynaecology, University Hospital, Eberhard Karls University, Tübingen, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Brucker
authors.affiliation: Division of Endocrinology, Diabetology, Angiology, Nephrology and Clinical Chemistry, Department of Internal Medicine, University Hospital, Eberhard Karls University, Tübingen, Germany.|Institute for Diabetes Research and Metabolic Diseases, Helmholtz Centre Munich, University of Tübingen, Tübingen, Germany.|German Centre for Diabetes Research (DZD), Tübingen, Germany.
authors.forename: H-U
authors.initials: HU
authors.lastname: Häring
authors.affiliation: Division of Endocrinology, Diabetology, Angiology, Nephrology and Clinical Chemistry, Department of Internal Medicine, University Hospital, Eberhard Karls University, Tübingen, Germany.|Institute for Diabetes Research and Metabolic Diseases, Helmholtz Centre Munich, University of Tübingen, Tübingen, Germany.|German Centre for Diabetes Research (DZD), Tübingen, Germany.|Department of Pharmacy and Biochemistry, Institute of Pharmaceutical Sciences, Tübingen, Germany.|Interfaculty Centre for Pharmacogenomics and Pharma Research, Eberhard Karls Universität Tübingen, Tübingen, Germany.|Institute for Diabetes and Obesity, Helmholtz Diabetes Centre, Helmholtz Zentrum München, German Research Centre for Environmental Health (GmbH), Neuherberg, Germany.
authors.forename: H
authors.initials: H
authors.lastname: Preissl
authors.affiliation: Division of Endocrinology, Diabetology, Angiology, Nephrology and Clinical Chemistry, Department of Internal Medicine, University Hospital, Eberhard Karls University, Tübingen, Germany.|Institute for Diabetes Research and Metabolic Diseases, Helmholtz Centre Munich, University of Tübingen, Tübingen, Germany.|German Centre for Diabetes Research (DZD), Tübingen, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Fritsche
mesh_terms: D000328:Adult; D001341:Autonomic Nervous System / Q000187:drug effects; D016640:Diabetes, Gestational / Q000175:diagnosis / Q000503:physiopathology*; D005260:Female; D005947:Glucose / Q000008:administration & dosage / Q000494:pharmacology*; D005951:Glucose Tolerance Test; D006340:Heart Rate, Fetal / Q000187:drug effects*; D006801:Humans; D053798:Magnetocardiography / Q000379:methods*; D011247:Pregnancy; D011296:Prenatal Diagnosis / Q000379:methods*; D055815:Young Adult
chemical_list: D005947:Glucose
keywords: Autonomic nervous system; fetal development; fetal programming; gestational diabetes; heart rate variability; magnetocardiography; oral glucose tolerance test