Key result
Maternal gestational diabetes mellitus was associated with lower left and right ventricular strain and higher left ventricular twist in infants over the first 3 days after birth (all p < 0.05).
Why the study?
Infants born to mothers with gestational diabetes mellitus have impaired myocardial performance and risk of pulmonary hypertension, motivating assessment of myocardial deformation and left ventricular rotational mechanics.
Does maternal gestational diabetes mellitus impair neonatal myocardial function and pulmonary vascular resistance in the first days of life?
Observational (n=80)
Does maternal gestational diabetes mellitus impair neonatal myocardial function and pulmonary vascular resistance in the first days of life?
p-value: p=<0.05
Infants born to mothers with gestational diabetes mellitus exhibit impaired myocardial deformation and increased pulmonary vascular resistance that persist through the first 3 days of life.
May identify subclinical dysfunction in GDM neonates; leaves open whether deformation metrics predict outcomes or warrant screening.
BACKGROUND AND AIMS: Infants born to mothers with gestational diabetes mellitus (GDM) have impaired myocardial performance and are at risk of pulmonary hypertension. We aimed to assess myocardial deformation and left ventricular (LV) rotational mechanics in this population. METHODS: We studied 40 infants of mothers with GDM and 40 control infants. Three echocardiograms were carried out over the first 3 days after birth. RESULTS: GDM infants had a lower gestation at birth and a thicker septal wall, a higher LV eccentricity index (indicating septal bowing), and a lower PAATi (indicating higher pulmonary vascular resistance) (all p < 0.05). GDM infants had lower LV strain, systolic and early diastolic strain rates, lower right ventricular (RV) strain, and early diastolic strain rates over the study period (all p < 0.05). By day 3, GDM infants had higher twist, torsion, and higher LV twist and untwist rates (all p < 0.05). GDM status was an independent predictor of LV and RV function and pulmonary vascular resistance (p < 0.01). CONCLUSION: Infants of mothers with GDM demonstrate important changes in myocardial function in addition to pulmonary vascular resistance that do not resolve by hospital discharge. The observed LV twist increase in GDM infants may be a compensatory mechanism for the lower longitudinal function in this cohort.
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Smith et al. (2021) conducted an observational in Gestational diabetes mellitus (neonatal effects) (n=80). Maternal gestational diabetes mellitus vs. Mothers without gestational diabetes mellitus was evaluated on Myocardial deformation and left ventricular rotational mechanics (p=<0.05). Maternal gestational diabetes mellitus was associated with lower left and right ventricular strain and higher left ventricular twist in infants over the first 3 days after birth (all p < 0.05).
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