Impact of maternal diabetes and obesity on fetal cardiac functions

In several developing industrial countries, the incidence of obesity among populations is spreading quickly and dramatically; also, the frequency of maternal obesity is in continuous elevation, which represents a considerable public health problem. Maternal hyperglycemia is a common gestational risk factor for the fetus. Several studies proposed that maternal DM and obesity lead to intrauterine impacts which induce changes in the fetal myocardium, and the pre-pregnancy obesity and diabetes are accompanied with development of cardiovascular alterations in the offspring and subsequent pathological changes in their early life. The aim of this study is to assess the cardiac function in fetuses of obese pregnant women (FOW) and fetuses of diabetic women (FDW) in comparison with fetuses of normal pregnant women (FNW) using tissue Doppler imaging.

There was impairment in systolic and diastolic cardiac function in both fetuses of obese and diabetic women with decreased global longitudinal strain tissue Doppler velocities at 30 weeks of gestation compared to fetuses of normal women.

Imaging of the fetus of pregnant women by Echo Doppler at about 30 weeks of gestations showed a reduced cardiac function of fetuses of obese and diabetic women matched with fetuses of normal BMI women. Our finding proposed that early subclinical alterations in the fetal cardiac output can arise from maternal obesity alone. This explains the predilection of children of obese mothers at advanced ages to cardiovascular disorder.