糖尿病母亲胎儿和新生儿的心肌病和心功能。
Cardiomyopathy and cardiac function in fetuses and newborns of diabetic mothers.
机构信息
Universidade da Região de Joinville (UNIVILLE), Departamento de Medicina, Joinville, SC, Brazil.
Universidade da Região de Joinville (UNIVILLE), Departamento de Medicina, Joinville, SC, Brazil.
出版信息
J Pediatr (Rio J). 2021 Sep-Oct;97(5):520-524. doi: 10.1016/j.jped.2020.10.003. Epub 2020 Nov 8.
OBJECTIVE
To evaluate cardiac function and structural changes in children of diabetic mothers in the fetal and neonatal period using Doppler-echocardiographic data.
METHOD
A prospective, descriptive observational study conducted in a private and tertiary care service for high-risk pregnant women. It included 48 children of mothers with gestational diabetes mellitus (GDM) considered clinically compensated during pregnancy, with a single fetus and absence of malformations. Myocardial thickness, shortening fraction, left ventricular (LVMPI) and right ventricular (RVMPI) myocardial performance index, and mitral and tricuspid valve E/A ratio were evaluated in 96 echocardiographic exams with Doppler.
RESULTS
The hypertrophic cardiomyopathy was 29% vs 6% p = 0.006 in the prenatal and postnatal periods respectively. The shortening fraction was 0% vs 6% p = 0.242 in the fetuses and newborns respectively. The myocardial performance index of the right ventricle was 12% vs 54% p ≤ 0.001, and on the left ventricle 27% vs 60% p = 0.001 in the prenatal and postnatal periods respectively. The ratio of mitral valve E/A waves was 6% vs 50% p ≤ 0.001 and the ratio of tricuspid valve E/A waves was 0% vs 27% p ≤ 0.001 in the fetuses and newborns respectively.
CONCLUSION
A decrease in the rate of myocardial hypertrophy and changes in cardiac function parameters were observed in the fetal and neonatal periods.
目的
利用多普勒超声心动图数据评估胎儿和新生儿期糖尿病母亲的子女的心脏功能和结构变化。
方法
这是一项在私人和三级高危孕妇护理服务机构进行的前瞻性描述性观察研究。共纳入 48 名患有妊娠期糖尿病（GDM）的母亲所生的子女，这些母亲在妊娠期被认为是临床代偿的，且怀有单胎且无畸形。对 96 次多普勒超声心动图检查的心肌厚度、缩短分数、左心室（LVMPI）和右心室（RVMPI）心肌性能指数以及二尖瓣和三尖瓣 E/A 比值进行评估。
结果
产前和产后分别有 29%和 6%的患儿出现肥厚型心肌病（p=0.006）。胎儿和新生儿的收缩分数分别为 0%和 6%（p=0.242）。右心室心肌性能指数分别为 12%和 54%（p≤0.001），左心室分别为 27%和 60%（p=0.001）。二尖瓣 E/A 波比值分别为 6%和 50%（p≤0.001），三尖瓣 E/A 波比值分别为 0%和 27%（p≤0.001）。
结论
在胎儿和新生儿期观察到心肌肥厚率降低和心脏功能参数变化。
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