Assessment of Myocardial Function in Infants of Mothers with Gestational Diabetes Mellitus Using Deformation Imaging over the First Year of Age

Abstract

To assess serial myocardial performance and pulmonary vascular resistance (PVR) in infants of mothers with gestational diabetes mellitus (GDM) over the first year of life. This was a prospective, observational study. Echocardiography was performed at birth, 6months, and 1year of age. Pulmonary artery acceleration time and left ventricular (LV) eccentricity index provided surrogate measurements of PVR. Biventricular function was assessed by tissue Doppler imaging and deformation analysis. Fifty infants of mothers with GDM were compared with 50 controls with no difference in gestation (38.9±0.8 weeks vs 39.3±0.9weeks; P=.05) or birthweight (3.55±0.49 kg vs 3.56±0.41kg; P=.95). At 1 year of age, the pulmonary artery acceleration time was lower (70±11 vs 79±10; P=.01) in the GDM group. LV global longitudinal strain (24.7±1.9 vs 28.8±1.8 %; P<.01), LV systolic strain rate (1.8±0.2 vs 2.1±0.3 1/s; P<.01), and RV free wall strain (31.1±4.8 vs 34.6±3.9 %; P<.01) were lower in the GDM cohort at 1year of age (all P values adjusted for gestation, mode of delivery, and maternal body mass index). Our findings demonstrate higher indices of PVR and lower biventricular function in infants ofmothers with GDM compared with controls at each time point assessed in this study over the first year of life.