Myocardial hypertrophy in fetuses of women with gestational diabetes

Abstract

Fetuses of diabetic mothers are known to have structural and functional cardiac changes. There are minuscule data on fetal cardiac changes from the Indian subcontinent. Hence, this study aimed to detect myocardial hypertrophy using 2D and M-mode fetal echocardiography (ECHO) in South Indian women with gestational diabetes mellitus (GDM) in their late phase of pregnancy. We have compared ECHO findings among nondiabetic controls and well-controlled and poorly controlled GDM through a cross-sectional observational study. Myocardial and interventricular septum (IVS) thicknesses were measured at the end of systole and diastole. The study included a total of 247 pregnant women; among them, 152 were diabetics [(well-controlled (n = 74) and poorly controlled (n = 78)], and 95 were nondiabetic controls. Myocardial hypertrophy is evident only beyond 29 weeks of gestation. During 29–34 weeks, myocardial hypertrophy is less severe among those with glycemic control. The fetuses beyond 35 weeks have a consistent and significant progressive thickening of fetal myocardium in all dimensions (p-value < 0.05). The overall thickness of ventricular walls and IVS increases with the diabetic status from nondiabetic controls to poorly controlled GDM women. There is a clear need to explore the perinatal implications of structural changes, considering the huge burden of diabetes in the Indian population.