Department of Obstetrics and Gynaecology, Gazi University, Ankara, Turkey.
Department of Obstetrics and Gynaecology, Ankara Atatürk Sanatoryum Research and Training Hospital, Ankara, Turkey.
J Clin Ultrasound. 2024 Nov-Dec;52(9):1265-1272. doi: 10.1002/jcu.23776. Epub 2024 Aug 9.
This study aimed to compare cardiac morphological and functional changes in fetuses of patients with diet-regulated gestational diabetes mellitus (GDM-A1), insulin-regulated GDM (GDM-A2), and a control group.
A prospective cohort study included pregnant women aged 18-40 years with singleton pregnancies. Fetal biometric, cardiac morphological, and functional measurements were recorded using Z-scores at 34-37 weeks of gestation.
The study included 87 patients. Both right and left ventricular wall thicknesses were significantly different between the three groups (p < 0.001 and p < 0.001, respectively). Z-scores of the mitral valve, left and right EDD were significantly lower in GDM-A1 and GDM-A2 groups compared to the control group (p < 0.001, p < 0.001, p = 0.002, respectively). Right and left ventricular areas were decreased only in GDM-A2 group compared to the control group (p = 0.003 and p = 0.001, respectively). MPI and IVRT values were also significantly higher in the same groups (p = 0.016, p < 0.001, respectively).
Gestational diabetes increased IVS and ventricular wall thicknesses in both right and left ventricles, irrespective of whether it was controlled by diet or insulin. Cardiac functional changes were observed in the GDM-A2 group.
本研究旨在比较饮食调节型妊娠期糖尿病（GDM-A1）、胰岛素调节型 GDM（GDM-A2）患者与对照组胎儿心脏形态和功能的变化。
一项前瞻性队列研究纳入了年龄在 18-40 岁、单胎妊娠的孕妇。在妊娠 34-37 周时，使用 Z 评分记录胎儿的生物测量、心脏形态和功能测量值。
本研究共纳入 87 例患者。三组之间右、左心室壁厚度均有显著差异（p<0.001 和 p<0.001）。与对照组相比，GDM-A1 和 GDM-A2 组的二尖瓣、左、右 EDD Z 评分显著降低（p<0.001、p<0.001、p=0.002）。与对照组相比，仅 GDM-A2 组的右、左心室面积减小（p=0.003 和 p=0.001）。同一组的 MPI 和 IVRT 值也显著升高（p=0.016、p<0.001）。
妊娠期糖尿病会增加胎儿左右心室的 IVS 和心室壁厚度，无论是否通过饮食或胰岛素控制。在 GDM-A2 组观察到心脏功能变化。
