Peng Yao, Feng Wei, Wei Zixian, Liao Xue, He Yang, Chang Caihong, Gan Ling, Zhang Jiaqi
Department of Ultrasound imaging, Postgraduate Union training base of Xiangyang No.1 People's Hospital, School of Medicine, Wuhan University of Science and Technology, Xiangyang, 441000, Hubei, China.
Hubei Provincial Clinical Research Center for Accurate Fetus Malformation Diagnosis, Department of Ultrasound, Xiangyang No. 1 People's Hospital, Hubei University of Medicine, Xiangyang 441000, China.
Early Hum Dev. 2025 Jan;200:106168. doi: 10.1016/j.earlhumdev.2024.106168. Epub 2024 Dec 3.
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.
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.
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.
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.
妊娠期糖尿病（GDM）可导致胎儿心脏结构和功能发生变化，对长期心血管健康具有潜在影响。本研究旨在通过使用创新的胎儿心脏量化（Fetal HQ）技术评估GDM妊娠胎儿的这些心脏适应性变化，以详细评估结构和功能参数。
2023年3月至2024年10月在襄阳市第一人民医院进行了一项前瞻性研究，纳入382名孕中期和孕晚期孕妇，其中167例为GDM患者，215例为健康对照。使用Fetal HQ进行胎儿心脏评估，该技术可直接测量心脏变形和功能。分析左心室（LV）和右心室（RV）尺寸、整体纵向应变（GLS）和面积变化分数（FAC）等关键参数。还收集了孕妇的临床数据，包括血糖水平和体重指数（BMI）。进行统计分析以比较两组之间的心脏参数。
在胎儿心脏尺寸方面观察到显著差异，GDM组左心室舒张末期面积更大（2.04±0.73 cm对1.81±0.69 cm，p = 0.002），右心室GLS更低（-20.1±5.3%对-22.6±4.6%，p = 0.000）。其他功能参数，包括左心室GLS和FAC，两组之间未显示出显著差异。相关性分析显示孕妇糖化血红蛋白水平与右心室FAC之间存在显著正相关（r = 0.348，p = 0.036），表明孕妇血糖控制可能影响胎儿心脏功能。
研究结果表明，GDM与胎儿心脏形态改变有关，特别是左心室，右心室功能受损，表现为GLS降低。这些结果突出了孕妇高血糖对胎儿心脏发育的潜在影响，并强调了在GDM合并妊娠中监测胎儿心脏健康的重要性。Fetal HQ技术的应用为早期检测这一高危人群的心脏功能障碍提供了有价值的工具。
