GDM links to increased neonatal myocardial hypertrophy via ANGPTL7: prospective cohort study

BACKGROUND: Gestational diabetes mellitus (GDM) can negatively impact newborn cardiac health, particularly causing myocardial hypertrophy. This study examined the relationship between umbilical cord blood levels of angiopoietin-like protein 7 (ANGPTL7) in term neonates born to mothers with GDM and myocardial development, assessing its potential as an early predictive marker. METHODS: The study involved 46 newborns exposed to GDM and 46 healthy controls. Measure the interventricular septum (IVS) thickness through cardiac ultrasound and evaluate the level of ANGPTL7 in umbilical cord blood using the ELISA method. RESULTS: The incidence of myocardial hypertrophy in the GDM group was 19.6%, significantly higher than 0% in the control group, and increased to 27.3% in neonates of mothers with GDM and poor glycaemic control. ANGPTL7 levels in the GDM group were significantly elevated compared to the control group (1.87 vs. 1.11 ng/mL). Furthermore, these levels were positively correlated with IVS thickness. In the poorly-controlled GDM subgroup (GDM-A), neonates had significantly higher ANGPTL7 levels and IVS/LVPW ratio (1.19 vs. 1.03), indicating more severe myocardial abnormalities. CONCLUSION: ANGPTL7 may contribute to myocardial hypertrophy in GDM neonates by promoting insulin resistance. Monitoring ANGPTL7 levels in umbilical cord blood could help identify high-risk neonates and guide optimal glycaemic management during pregnancy. Although the sample size was small, the study offers new evidence of ANGPTL7's clinical utility. Future research should expand the sample size and investigate the molecular mechanisms of ANGPTL7 to develop personalised interventions. TRIAL REGISTRATION: This study was not registered prospectively.