Evaluation of fetal myocardial performance index in gestational diabetes mellitus

IF 1.3 4区 医学 Q3 PEDIATRICS Congenital Anomalies Pub Date : 2023-07-26 DOI:10.1111/cga.12531
Merve Ozturk, Zahid Agaoglu, Filiz Halici Ozturk, Kadriye Yakut, Fatma Doğa Öcal, Yuksel Oguz, Turhan Caglar
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Abstract

This study aimed to compare fetal myocardial performance index (MPI) between fetuses of pregnant women with gestational diabetes mellitus (GDM) and healthy controls and to evaluate the relationship between MPI and maternal glucose levels. This was a prospective study of 90 pregnant women, including 50 pregnancies with GDM (27 pregnancies with insulin-regulated GDM and 23 pregnancies with diet-regulated GDM) and 40 healthy controls. Isovolumetric contraction time (ICT) + isovolumetric relaxation time (IRT)/ejection time (ET) were used to calculate the MPI (MPI = [ICT + IRT]/ET). Fetal MPI, PR interval, E/A ratio, maternal plasma glucose levels on the day of MPI measurement, and neonatal outcomes were compared. The fetal left-MPI was significantly higher in the GDM group than healthy controls (0.43 ± 0.04 vs. 0.40 ± 0.06, p = 0.007). The best cut-off level for MPI was >0.41 to predict adverse perinatal outcomes (sensitivity: 70%, specificity: 68%, area under the curve: 0.715, 95% confidence interval: 0.5143–0.8205, p < 0.001). The fetal MPI values showed no correlation with maternal plasma fasting, postprandial glucose, and hemoglobin A1c (HbA1c) levels. Reduced E/A ratio, higher neonatal intensive care unit admissions, and the need for cesarean delivery were detected in the GDM group. Fetal MPI is impaired in women with GDM, and the need for insulin therapy is associated with higher MPI values and adverse neonatal outcomes. Fetal MPI can help detect fetuses with potential adverse outcome risks, owing to impaired fetal cardiac function.

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妊娠期糖尿病胎儿心肌功能指标的评价
本研究旨在比较妊娠期糖尿病(GDM)孕妇的胎儿心肌性能指数(MPI)与健康对照,并探讨MPI与母体血糖水平的关系。这是一项对90名孕妇的前瞻性研究,其中包括50名患有GDM的孕妇(27名患有胰岛素调节型GDM, 23名患有饮食调节型GDM)和40名健康对照。采用等容收缩时间(ICT) +等容松弛时间(IRT)/喷射时间(ET)计算MPI (MPI = [ICT + IRT]/ET)。比较胎儿MPI、PR间期、E/A比、MPI测量当日孕妇血浆葡萄糖水平及新生儿结局。GDM组胎儿左mpi显著高于健康对照组(0.43±0.04比0.40±0.06,p = 0.007)。MPI预测不良围产期结局的最佳临界值为0.41(敏感性:70%,特异性:68%,曲线下面积:0.715,95%可信区间:0.5143-0.8205,p < 0.001)。胎儿MPI值与母体空腹血浆、餐后血糖和血红蛋白A1c (HbA1c)水平无相关性。GDM组的E/A比降低,新生儿重症监护病房入院率升高,需要剖宫产。GDM妇女胎儿MPI受损,需要胰岛素治疗与较高的MPI值和不良新生儿结局相关。胎儿MPI可以帮助发现由于胎儿心功能受损而有潜在不良结局风险的胎儿。
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来源期刊
Congenital Anomalies
Congenital Anomalies PEDIATRICS-
自引率
0.00%
发文量
49
审稿时长
>12 weeks
期刊介绍: Congenital Anomalies is the official English language journal of the Japanese Teratology Society, and publishes original articles in laboratory as well as clinical research in all areas of abnormal development and related fields, from all over the world. Although contributions by members of the teratology societies affiliated with The International Federation of Teratology Societies are given priority, contributions from non-members are welcomed.
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