The correlation of fetal cardiac function with gestational diabetes mellitus (GDM) and oxidative stress levels

Phudit Jatavanhttp://orcid.org/https://orcid.org/0000-0002-4176-3501 1 , Thitikarn Lerthiranwong 1 , Rattanaporn Sekararithi 1 , Thidarat Jaiwongkam 2 , Sirinart Kumfu 2 , Nipon Chattipakorn 2  and Theera Tongsong 1
  • 1 Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
  • 2 Cardiac Electrophysiology Research and Training Center (CERT), Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
Phudit JatavanORCID iD: https://orcid.org/0000-0002-4176-3501, Thitikarn Lerthiranwong
  • Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
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, Rattanaporn Sekararithi
  • Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
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, Thidarat Jaiwongkam
  • Cardiac Electrophysiology Research and Training Center (CERT), Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
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, Sirinart Kumfu
  • Cardiac Electrophysiology Research and Training Center (CERT), Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
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, Nipon Chattipakorn
  • Cardiac Electrophysiology Research and Training Center (CERT), Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
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and Theera Tongsong
  • Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
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Abstract

Background

The primary objective of this study was to compare the fetal cardiac performance index (Tei index) between the fetuses of gestational diabetes mellitus (GDM) mothers and non-GDM mothers; and the secondary objective was to compare various other parameters of fetal cardiac function as well as maternal oxidative stress levels between the groups of GDM and non-GDM mothers.

Methods

A cross-sectional study was conducted on pregnant women at 24–28 weeks of gestation. All of the participants underwent 100 g, 3-h oral glucose tolerance test (OGTT) as a diagnostic test for GDM and were categorized as non-GDM and GDM group. All participants had fetal echocardiography performed for cardiac function, and then maternal blood samples were collected for biomarker measurements.

Results

A total of 80 pregnant women, including 43 in the GDM group and 37 in the non-GDM group, were included in the study. The maternal serum 8-isoprostane (8IsoP), tumor necrosis factor-α (TNF-α) and interleukin (IL)-10 levels were significantly higher in the GDM group than those in the non-GDM group (P: 0.028, P: 0.019 and P: 0.031, respectively). The fetal cardiac function parameters were not significantly different between the two groups. Regardless of the GDM status, the fetuses with high levels of oxidative stress (8Isop ≥1000 pg/mg protein) had a significantly higher rate of impaired shortening fraction (SF) of the left ventricle (P: 0.001).

Conclusion

GDM is significantly associated with an increase in the oxidative stress process, and a high level of oxidative stress was significantly associated with left ventricular (LV) function impairment. Though a correlation between GDM and fetal cardiac function impairment was not clearly demonstrated in this study, this study suggests that GDM patients with a high level of oxidative stress should be evaluated for fetal cardiac function.

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