Key result
Prior gestational diabetes linked to subclinical myocardial dysfunction in ~63% of women 4 years postpartum.
Why the study?
No previous study had comprehensively evaluated biventricular and biatrial myocardial strain parameters in women with previous gestational diabetes mellitus.
Does previous gestational diabetes mellitus increase the risk of subclinical myocardial dysfunction and early carotid atherosclerosis at 4 years postpartum?
Cohort (n=62)
Does previous gestational diabetes mellitus increase the risk of subclinical myocardial dysfunction and early carotid atherosclerosis at 4 years postpartum?
Women with previous gestational diabetes, particularly those with higher third-trimester BMI and HbA1c, have a significantly increased risk of subclinical myocardial dysfunction and early carotid atherosclerosis at 4 years postpartum.
Answers are grounded in this paper and cite their sources.
May support targeted postpartum cardiac surveillance in prior gestational diabetes; hypothesis-generating and leaves open need for prospective trials.
Background/Objectives: No previous study has provided a comprehensive evaluation of all biventricular and biatrial myocardial strain parameters in women with previous gestational diabetes mellitus (pGDM). Accordingly, we aimed at investigating the structural and myocardial deformation properties of all cardiac chambers in a cohort of pGDM women at 4 years postpartum. Methods: A consecutive cohort of pGDM women was compared to a control group of healthy women with previous uncomplicated pregnancy, matched by age, ethnicity and gestational week, at 4 years postpartum. Both groups of women underwent transthoracic echocardiography (TTE) implemented with speckle-tracking echocardiography (STE) and subsequent carotid ultrasonography. The primary endpoint was subclinical myocardial dysfunction, defined as left-ventricular (LV) global longitudinal strain (GLS) < 20%, whereas the secondary endpoint was early carotid atherosclerosis, defined as common carotid artery (CCA) intima-media thickness (IMT) ≥ 0.7 mm. Results: A total of 32 pGDM women (39.1 ± 6.5 yrs) and 30 matched healthy controls (40.8 ± 5.0 yrs) were analyzed. Despite normal and similar systolic function on conventional TTE, all biventricular and biatrial strain parameters were significantly lower in pGDM women than controls. Mean follow-up period was 4.0 ± 1.9 yrs. During follow-up, 62.5% of pGDM women developed subclinical myocardial dysfunction, and 78.1% of them were diagnosed with early carotid atherosclerosis. Third-trimester BMI (OR 1.88, 95% CI 1.19–2.98) and third-trimester glycosylated hemoglobin (HbA1C) (OR 2.34, 95% CI 1.08–5.04) were independently associated with the primary endpoint. Third-trimester BMI and HbA1C also independently predicted the secondary endpoint. Third-trimester BMI > 27 kg/m2 and HbA1C > 33 mmol/mol showed the best sensitivity and specificity for predicting both endpoints. Conclusions: Women with a previous history of GDM complicated by overweight/obesity and uncontrolled diabetes have a significantly increased risk of subclinical myocardial dysfunction and early carotid atherosclerosis at 4 years postpartum.
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Sonaglioni et al. (2025) conducted a cohort in Previous gestational diabetes mellitus (pGDM) (n=62). Previous gestational diabetes mellitus vs. Healthy women with previous uncomplicated pregnancy was evaluated on Subclinical myocardial dysfunction, defined as left-ventricular (LV) global longitudinal strain (GLS) < 20%. At 4 years postpartum, 62.5% of women with previous gestational diabetes developed subclinical myocardial dysfunction, with third-trimester BMI and HbA1C as independent predictors.
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