Evaluation of Ventricular Dyssynchrony Measured by Tissue Doppler Indices in Fetuses of Diabetic Mothers: A Case-Control Study.

BACKGROUND

This study aimed to evaluate the effects of overt maternal diabetes on fetal cardiac function.

METHODS

In this case-control study, 26 pregnant women with overt diabetes (the case group) and 26 women with uncomplicated pregnancies (the control group) were examined using tissue Doppler echocardiography. Cardiac function was assessed twice in the fetal period (18-22 weeks and 28 weeks of gestation) and once in the neonatal period (1 week postnatal). Fetal cardiac function was assessed using early-diastolic maximum velocity index (Em), end-diastolic maximum velocity index (Am), Em/Am, left ventricular myocardial function index (LVMPI), and interventricular mechanical delay index (IVMDI).

RESULTS

The case and control groups were not significantly different in maternal and gestational age in fetal Doppler evaluation. Em (P=0.007), Am (P<0.001), LVMPI (P=0.003), and IVMDI (P=0.026) were significantly higher in the case group than in the control group, while there was no significant difference in Em/Am (P=0.264). Eight fetuses (30.8%) of diabetic mothers had dyssynchrony, while no cases of dyssynchrony were seen in fetuses of non-diabetic mothers (P=0.004). Infants of diabetic mothers were 8.8 times more likely to develop adverse neonatal outcomes than infants of healthy mothers (RR: 8.8, 95% CI: 1.71 to 45.31, P=0.009).

CONCLUSION

The findings of the current study revealed significant cardiac dysfunction and dyssynchrony in fetuses of diabetic pregnant women. Additionally, IVMDI and LVMPI can be used to predict adverse neonatal outcomes in pregnancies complicated with overt diabetes.