The impact of gestational diabetes mellitus on neonatal cardiac development and function
Objective To investigate the impact of maternal gestational diabetes mellitus(GDM)on neonatal cardiac function and analyze its echocardiographic characteristics.Methods Among the full-term newborns without high-risk delivery diseases admitted to the neonatal ward of Yidu Central Hospital of Weifang from January 2019 to January 2022,95 full-term newborns of GDM mothers were selected as the GDM group,and 90 newborns of non-GDM mothers were selected as the control group.The birth blood glucose,birth weight,birth length,myocardial injury markers[creatine kinase(CK),creatine kinase isoenzyme(CK-MB),high-sensitive cardiac troponin T(hs-cTnT)]levels and neonatal heart measurement data,including ascending aorta diameter,left atrial anteroposterior diameter,right ventricular anteroposterior diameter,left ventricular anteroposterior diameter,pulmonary artery diameter,interventricular septal thickness,ejection fraction and the incidence of congenital heart disease,were detected and compared between the two groups of newborns.Multivariate linear regression analysis was conducted to identify factors influencing interventricular septal hypertrophy in neonates of the GDM group.Results The differences in birth weight,birth length,and birth blood glucose levels between the GDM group and the control group were statistically significant(t=-6.627,-8.378,15.561,respectively,P＜0.01).There were significant differences in CK,CK-MB and hs-cTnT between the GDM group and the control gruop(t=-5.028,-10.510,-8.804,respectively,P＜0.01).Significant differences were observed in the ascending aorta diameter,left atrial anteroposterior diameter,right ventricular anteroposterior diameter,pulmonary artery diameter and interventricular septal thickness between the GDM group and the control group(t=-3.729,-5.612,-2.703,-3.516,-7.647,-6.028,respectively,P＜0.01).However,there was no significant difference in ejection fraction between the two groups(P＞0.05).The incidence of congenital heart disease was significantly different in the GDM group compared to the control group(x2=5.746,P＜0.05).Correlation analysis indicated that interventricular septal thickness was negatively correlated with neonatal birth blood glucose levels(r=-0.305,P＜0.01),and positively correlated with birth weight,serum hs-cTnT(r=0.546,0.566,respectively,P＜0.01),and positively correlated with maternal serum C-peptide levels and glycosylated hemoglobin(r=0.222,0.634,respectively,P＜0.01).Multivariate linear regression analysis showed that neonatal birth weight,serum hs-cTnT level,and maternal glycosylated hemoglobin were influencing factors of interventricular septal thickness(t=3.628,5.777,2.538,respectively,P＜0.05).Conclusion Maternal GDM has adverse effects on the cardiac function of neonates.Monitoring serum myocardial injury markers and performing echocardiography can serve as early indicators for diagnosing cardiac injury in neonates born to mothers with GDM.
万方数据
维普
