Effect of Gestational Diabetes Mellitus on Neonatal Myocardial Function

Neonatology ◽  
2021 ◽  
Vol 118 (1) ◽  
pp. 64-72
Author(s):  
Aisling Smith ◽  
Orla Franklin ◽  
Naomi McCallion ◽  
Fionnouala Breatnach ◽  
Afif EL-Khuffash
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Pulmonary Vascular Resistance ◽  
Vascular Resistance ◽  
Myocardial Function ◽  
Left Ventricular ◽  
Compensatory Mechanism ◽  
Strain Rates ◽  
Rotational Mechanics

Background and Aims: Infants born to mothers with gestational diabetes mellitus (GDM) have impaired myocardial performance and are at risk of pulmonary hypertension. We aimed to assess myocardial deformation and left ventricular (LV) rotational mechanics in this population. Methods: We studied 40 infants of mothers with GDM and 40 control infants. Three echocardiograms were carried out over the first 3 days after birth. Results: GDM infants had a lower gestation at birth and a thicker septal wall, a higher LV eccentricity index (indicating septal bowing), and a lower PAATi (indicating higher pulmonary vascular resistance) (all p < 0.05). GDM infants had lower LV strain, systolic and early diastolic strain rates, lower right ventricular (RV) strain, and early diastolic strain rates over the study period (all p < 0.05). By day 3, GDM infants had higher twist, torsion, and higher LV twist and untwist rates (all p < 0.05). GDM status was an independent predictor of LV and RV function and pulmonary vascular resistance (p < 0.01). Conclusion: Infants of mothers with GDM demonstrate important changes in myocardial function in addition to pulmonary vascular resistance that do not resolve by hospital discharge. The observed LV twist increase in GDM infants may be a compensatory mechanism for the lower longitudinal function in this cohort.

scholarly journals Association of Gestational Diabetes Mellitus With Left Ventricular Structure and Function: The CARDIA Study

Diabetes Care ◽  
2016 ◽  
Vol 39 (3) ◽  
pp. 400-407 ◽  
Author(s):  
Duke Appiah ◽  
Pamela J. Schreiner ◽  
Erica P. Gunderson ◽  
Suma H. Konety ◽  
David R. Jacobs ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Left Ventricular ◽  
Structure And Function ◽  
Left Ventricular Structure ◽  
Ventricular Structure ◽  
And Function

scholarly journals Experimental Gestational Diabetes Mellitus Induces Blunted Vasoconstriction and Functional Changes in the Rat Aorta

2014 ◽  
Vol 2014 ◽  
pp. 1-11 ◽  
Author(s):  
Cecilia Tufiño ◽  
Cleva Villanueva-López ◽  
Maximiliano Ibarra-Barajas ◽  
Ismael Bracho-Valdés ◽  
Rosa Amalia Bobadilla-Lugo
Keyword(s):  
Diabetes Mellitus ◽  
Angiotensin Ii ◽  
Gestational Diabetes ◽  
Protein Expression ◽  
Gestational Diabetes Mellitus ◽  
Early Stage ◽  
Compensatory Mechanism ◽  
Functional Changes ◽  
Cox 2 ◽  
Cox 1

Diabetic conditions increase vascular reactivity to angiotensin II in several studies but there are scarce reports on cardiovascular effects of hypercaloric diet (HD) induced gestational diabetes mellitus (GDM), so the objective of this work was to determine the effects of HD induced GDM on vascular responses. Angiotensin II as well as phenylephrine induced vascular contraction was tested in isolated aorta rings with and without endothelium from rats fed for 7 weeks (4 before and 3 weeks during pregnancy) with standard (SD) or hypercaloric (HD) diet. Also, protein expression of AT1R, AT2R, COX-1, COX-2, NOS-1, and NOS-3 and plasma glucose, insulin, and angiotensin II levels were measured. GDM impaired vasoconstrictor response(P<0.05versus SD) in intact (e+) but not in endothelium-free (e−) vessels. Losartan reduced GDM but not SD e− vasoconstriction(P<0.01versus SD). AT1R, AT2R, and COX-1 and COX-2 protein expression were significantly increased in GDM vessels(P<0.05versus SD). Results suggest an increased participation of endothelium vasodilator mediators, probably prostaglandins, as well as of AT2vasodilator receptors as a compensatory mechanism for vasoconstrictor changes generated by experimental GDM. Considering the short term of rat pregnancy findings can reflect early stage GDM adaptations.

scholarly journals Effect of Gestational Diabetes Mellitus on Gross Morphological Structure of Preterm Placenta

1970 ◽  
Vol 8 (1) ◽  
pp. 34-38 ◽  
Author(s):  
Fahima Akhter ◽  
Mst Laila Anjuman Banu ◽  
Roxana Ferdausi
Keyword(s):  
Diabetes Mellitus ◽  
Preterm Birth ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Morphological Structure ◽  
Diabetic Mother ◽  
Large For Gestational Age ◽  
Control Group ◽  
Compensatory Mechanism ◽  
Two Samples

Context: Preterm birth is the major cause of perinatal mortality and morbidity. For the last few decades, it has become an important issue in public health policies of developing countries. Gestational diabetes mellitus (GDM) is one of the high-risk factors for the preterm birth and altered fetal development. This pregnancy induced disorder leads to an increased level of all metabolic substances to the fetal circulation due to development of maternal insulin resistance. It imposes a heavy burden on the mother who is pregnant and these patients have a tendency toward metabolic instability. As there is an intimate relationship between the fetus and placenta, the present study aimed to observe the effect of this pregnancy induced disorder to the preterm placenta. Study design: The study was observational, analytical and cross sectional. Place and period of study: The study was carried out in the Department of Anatomy, BSMMU, Dhaka during the study period of January 2005 to December 2005. Materials and Methods: A total of forty-four samples were collected from women during 28 weeks to 36 completed weeks of gestation. Among them, twenty-two samples belonged to mothers having GDM and twenty-two belonged to normal pregnancy (control group). The placentas were examined to measure their diameter, thickness, cotyledons number, weight, and volume. Result: In this study, the GDM group showed significantly higher values for the variables of diameter, weight and volume. On the other hand, the thickness of the placenta showed lower values and cotyledons number showed higher values in GDM group but the result did not reach a significant level. Conclusion: The findings in this study supported that the gross morphological structure of the placentas in GDM mother did not present any specific, constant or uniform pattern of abnormality. Therefore, it is difficult to establish a clear cut correlation between the placental changes and diabetic state in the mother during pregnancy. However, increased placental weight, volume and diameter found in gestational diabetic mother have supported that these changes may be a long term compensatory mechanism, aiming to secure a sufficient nutrient supply to support the growth of large-for-gestational age (LGA) fetus. But the hormonal and metabolic abnormalities present in the diabetic mother and the fetus are important variables to be considered when studying the placenta. Key words: Preterm Placenta; GDM; Gross morphology. DOI: 10.3329/bja.v8i1.6107 Bangladesh Journal of Anatomy January 2010, Vol. 8 No. 1 pp. 34-38

A comparative study of left ventricular function during pregnancy without and with gestational hypertension and gestational diabetes mellitus

2021 ◽  
Vol 11 (5) ◽  
pp. 647-654
Author(s):  
Yibo Zhang ◽  
Xue Meng ◽  
Jing Long ◽  
Yong Pan ◽  
Jianhong Wu ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Pregnant Women ◽  
Gestational Hypertension ◽  
Left Ventricular ◽  
Normal Group ◽  
Disease Group ◽  
A Value ◽  
And Function

The use of nanoscale ultrasonic contrast agent greatly improved the reliability of ultrasonic technology detection, and it became an effective tool to detect a series of diseases. Gestational hypertension and Gestational Diabetes Mellitus (GDM) are unique and common complications during pregnancy, and they seriously affect women’s postnatal health. In this study, we evaluated the practical value of echocardiogram in evaluating Left Ventricular (LV) morphology and function changes during pregnancy with gestational hypertension and GDM. 46 pregnant women with gestational hypertension and GDM as disease group and 50 healthy pregnant women as normal group were included in the study. By echocardiogram analysis, the morphology, systole and diastole functions of LV were compared in both groups. With LV morphology change during pregnancy, LA volume (P = 0.011) of disease group was bigger than that of normal group and LV mass (P < 0.0001) and LVMi (P < 0.0001) of disease group were higher than that of normal group. However, the LVPWd (P < 0.0001) and IVSd (P < 0.0001) of disease group thickened clearly relative to that of the normal group. However, these values, including LVIDd (P = 0.185), EF value (P = 0.779), FS value (P = 0.740) and Cardiac Index (P = 0.444) for their cardiac LV systolic functions of two groups, had very few large-scale differences. Compared to normal pregnant cardiac, the E value (P = 0.014) was lower and the A value (P < 0.0001) was higher in the disease group. Moreover, E/A ratio (P < 0.0001) was obviously less than that in the experimental. According to TDI measures for both groups, the E’ value (P < 0.0001) and ratio of E/A’ (P < 0.0001) were lower and A’ value (P = 0.003) was slightly higher in the disease group compared with normal group. In recent years, we found that the E/E’ value (P = 0.0002) in the disease group was also higher. In summary, LV diastolic function during pregnancy with complications changes pregnant LV morphology and function. Echocardiogram can be used for testing and monitoring these changes as one of simple and reliable inspection methods.

Abstract #1012: Gestational Diabetes Mellitus (GDM) in Bangladesh

2016 ◽  
Vol 22 ◽  
pp. 233-234
Author(s):  
Md Abdullah Mamun ◽  
Subrina Jesmin ◽  
Md. Arifur Rahman ◽  
Md Majedul Islam ◽  
Farzana Sohael ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus
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