Evaluation of Fetal Myocardial Performance Index in Gestational and Pregestational Diabetic Pregnancies

This study aimed to evaluate the modified myocardial performance index (MPI) in fetuses of mothers with pregestational diabetes mellitus (DM) and gestational diabetes mellitus (GDM) and to assess its relationship with adverse perinatal outcomes.

This case-control study included 157 singleton pregnancies divided into three groups: pregestational DM (n = 17), GDM (n = 52), and controls (n = 88). Fetal echocardiography was used to measure modified MPI, isovolumetric contraction time (ICT), isovolumetric relaxation time (IRT), ejection time (ET), and mitral E/A. Neonatal outcomes, including neonatal intensive care unit (NICU) admission and respiratory distress syndrome (RDS), were recorded. Statistical analyses were performed using appropriate tests.

Fetuses of diabetic mothers had significantly higher modified MPI and ICT values compared to controls (p = 0.007, p < 0.001 and p = 0.003, p < 0.001). NICU admission and RDS rates were also more frequent in pregnancies complicated by pregestational diabetes (p = 0.002 and p = 0.001, respectively). However, modified MPI was not associated with NICU admission or RDS (p > 0.05).

Elevated modified MPI and ICT in diabetic pregnancies may reflect subclinical fetal cardiac dysfunction, although they do not predict short-term adverse neonatal outcomes. Further prospective research is needed to establish the clinical utility of fetal modified MPI for risk stratification in diabetic pregnancies.