Abstract
BackgroundIn several developing industrial countries, the incidence of obesity among populations is spreading quickly and dramatically; also, the frequency of maternal obesity is in continuous elevation, which represents a considerable public health problem. Maternal hyperglycemia is a common gestational risk factor for the fetus. Several studies proposed that maternal DM and obesity lead to intrauterine impacts which induce changes in the fetal myocardium, and the pre-pregnancy obesity and diabetes are accompanied with development of cardiovascular alterations in the offspring and subsequent pathological changes in their early life. The aim of this study is to assess the cardiac function in fetuses of obese pregnant women (FOW) and fetuses of diabetic women (FDW) in comparison with fetuses of normal pregnant women (FNW) using tissue Doppler imaging.ResultsThere was impairment in systolic and diastolic cardiac function in both fetuses of obese and diabetic women with decreased global longitudinal strain tissue Doppler velocities at 30 weeks of gestation compared to fetuses of normal women.ConclusionImaging of the fetus of pregnant women by Echo Doppler at about 30 weeks of gestations showed a reduced cardiac function of fetuses of obese and diabetic women matched with fetuses of normal BMI women. Our finding proposed that early subclinical alterations in the fetal cardiac output can arise from maternal obesity alone. This explains the predilection of children of obese mothers at advanced ages to cardiovascular disorder.
Highlights
In several developing industrial countries, the incidence of obesity among populations is spreading quickly and dramatically; the frequency of maternal obesity is in continuous elevation, which represents a considerable public health problem
We postulated that obesity and maternal diabetes had an impact on fetal cardiac outputs; the purpose of this work was to assess the cardiac functions in the fetal heart of obese women (FOW) and fetuses of diabetic women (FDW) in comparison with fetuses of normal pregnant women (FNW)
All fetuses were assessed by full 2D echocardiographic assessment, as well as tissue Doppler imaging with special attention to ventricular functions comparing fetuses of normal women (FNW) group A
Summary
In several developing industrial countries, the incidence of obesity among populations is spreading quickly and dramatically; the frequency of maternal obesity is in continuous elevation, which represents a considerable public health problem. The main public health problems all over the world are overweight (obesity), type 2 diabetes, and cardiovascular disorder These communal disorders have a great effect on morbidity and mortality in the overall mature people [1]. Obesity is a chronic low-grade inflammatory disease The result of this inflammation is endothelial dysfunction, hypertension, insulin resistance, and cardiac dysfunction; fibrosis occurs in response to inflammation. Some inflammatory markers such as C-reactive protein and transforming growth factor (TGF)-β have been shown to enhance collagen accumulation in fetal myocardium; most likely, this induces fibrosis in fetal myocardium and impairs systolic and diastolic function and alter cardiac morphometry which leads to increase in wall thickness and hypertrophy [4]
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