Quantitative analysis of fetal cardiac structure and function in gestational diabetes mellitus using fetal HQ technology.

BACKGROUND

Gestational diabetes mellitus (GDM) can contribute to changes in fetal cardiac structure and function, with potential implications for long-term cardiovascular health. This study focuses on assessing these cardiac adaptations in fetuses from GDM pregnancies by using the innovative Fetal Heart Quantification (Fetal HQ) technology to provide a detailed evaluation of structural and functional parameters.

METHODS

A prospective study was conducted from March 2023 to October 2024 at Xiangyang No.1 People's Hospital, involving 382 pregnant women in their second and third trimesters, including 167 with GDM and 215 healthy controls. Fetal cardiac assessments were performed using Fetal HQ, which allows for direct measurement of cardiac deformation and function. Key parameters such as left ventricular (LV) and right ventricular (RV) dimensions, global longitudinal strain (GLS), and fractional area change (FAC) were analyzed. Maternal clinical data, including blood glucose levels and body mass index (BMI), were also collected. Statistical analyses were performed to compare the cardiac parameters between the two groups.

RESULTS

Significant differences were observed in fetal cardiac dimensions, with the GDM group exhibiting larger LV end-diastolic area (2.04 ± 0.73 cm vs. 1.81 ± 0.69 cm, p = 0.002) and lower RV GLS (-20.1 ± 5.3 % vs. -22.6 ± 4.6 %, p = 0.000). Other functional parameters, including LV GLS and FAC, did not show significant differences between groups. Correlation analysis revealed a significant positive relationship between maternal HbA1c levels and RV FAC (r = 0.348, p = 0.036), indicating that maternal glycemic control may influence fetal cardiac function.

CONCLUSIONS

The findings suggest that GDM is associated with altered fetal cardiac morphology, particularly in the left ventricle, and impaired right ventricular function, as evidenced by reduced GLS. These results highlight the potential impact of maternal hyperglycemia on fetal cardiac development and underscore the importance of monitoring fetal cardiac health in pregnancies complicated by GDM. The use of Fetal HQ technology provides a valuable tool for early detection of cardiac dysfunction in this high-risk population.