Association between sphericity and ventricular function in fetuses of diabetic mothers: A longitudinal study from the fetal to neonatal period.

Background: The impact of maternal diabetes on the fetal heart is complex and not fully understood. Objective: The study aimed to investigate how differenttypes and stages of maternal diabetes affect fetal heart function and ventricular remodeling during prenatal and postnatal periods. Methods: The study included 45 pregnant women with diabetes and 15 with uncomplicated pregnancies. Fetal echocardiograms were performed between 28-32 weeks of gestation using different techniques to assess cardiac function. Measurements of ventricular transverse and longitudinal diameters, as well as the sphericity index, were determined. Postnatal follow-up echocardiograms were also performed. Results: The diabetic pregnant group was divided into three subgroups: 15 with GDM and 30 with PGD, including 15 well-controlled and 15 uncontrolled cases. The E and E/A ratio values for the mitral and tricuspid valves were significantly lower in fetuses and neonates affected by diabetes compared to the healthy group. The Tei Doppler index for the left ventricle was significantly higher in pregnancies affected bydiabetes, affecting both fetuses and neonates. The right ventricle exhibited significant differences in all groups of diabetic pregnancies in fetuses and postnatally in cases of pregestational diabetes. The sphericity index differed significantly in all fetal diabetic groups and in neonates compared to controls, except for the LV in the GDM cohort. Postnatally, the sphericity index of the RV increased compared to fetal values, while the LV sphericity index remained unchanged. Conclusion: Maternal diabetes mellitus affects fetal cardiac function and structure, which may continue into the early days of life.