Abstract
IN FETUSES FROM PREGNANCIES COMPLICATED BY GESTATIONAL DIABETES MELLITUS GIORGIA BUSCICCHIO, LUCIA GENTILUCCI, ELISA CARBONI, STEFANO RAFFAELE GIANNUBILO, VALERIA BEZZECCHERI, ANDREA L. TRANQUILLI, Marche Polytechnic University, Institute of Maternal and Child Sciences, Ancona, Italy, AOU OO RR Ancona, Maternal-Neonatal Department, Ancona, Italy OBJECTIVE: To compare individual fetal heart rate (FHR) indexes, as determined by computerized analysis of cardiotocographic tracing, in pregnancies complicated by gestational diabetes mellitus (GDM). STUDY DESIGN: We studied 41 pregnant women affected by GDM on diet therapy and 41 controls with normal pregnancy matched for age, parity and gestation (37 weeks). FHR tracing was analyzed by computerized cardiotocography and results compared and related to neonatal umbilical artery cord blood collected at birth. RESULTS: The baseline FHR (GDM 144.00 G 10.97 vs. Controls 134.66 G 9.34 bpm, p ! 0.0001) and the duration of episodes of low variation (GDM 8.00 G 13.77 vs. Controls 0.15 G 0.79 n/min; p! 0.0001) were significantly higher in GDM than in the controls. Conversely, the number of fetal movements per h (GDM 5.11 G 27.72 vs. Controls 52.47 G 42.70; p ! 0.05) and the short-term variation GDM 7.87 G 3.96 vs. Controls 10.76 G 2.30 msec; p ! 0.0001) were significantly lower in GDM, as compared to controls. The baseline FHR and the duration of the episodes of low variation were negatively related to umbilical artery glycemia at birth while the short-term variation was positively related to. CONCLUSION: Reduced short-term variation, reduced fetal movements, longer episodes of low variation and increased FHR outline a reduced reactivity in GDM fetuses. Gestational diabetes mellitus, even when in a mild stage, has an impact on FHR, via a direct impact or glycemia or possibly by an intrinsic myocardial alteration.Computerized cardiotocography may allow to detect even those slight differences.
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