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Cardiac hemodynamics in early term neonates born with maternal gestational diabetes mellitus

Li Aiguo, Zhao Pu, Xi Xiaohong, Wu Bin, Zhang Yuqi, Liu Jiangqin

Published: Chin J Perinat Med, Dec. 2015, Vol.18, No.12 DOI:10.3760/cma.j.issn.1007-9408.2015.12.009

Objective: To investigate the early changes of cardiac output and vital signs in term neonates shortly after born from gestational diabetic women.

Methods: From January 2015 to April 2015, 22 term neonates of gestational diabetes mellitus (GDM) women with euglycemia during pregnancy (GDM group) and 20 term neonates of non-complicated gravidas (control group) in Shanghai First Maternity and Infant Hospital were enrolled. Neonates in both groups were measured by ultrasonic cardiac output monitor (USCOM) for cardiac hemodynamics index, including aortic peak flow velocity, pulmonary artery peak flow velocity, left cardiac output, right cardiac output and Smith Madigan inotropy index at one and two hours after birth. Vital signs including heart rate, respiratory rate, blood pressure and peripheral blood glucose were measured as well. Two independent sample t-test and Chi-square test were used for statistical analysis.

Results: The peripheral blood glucose of neonates in GDM group was significantly lower than that of the control [(3.0±0.4) vs (4.0±0.4) mmol/L, t=8.400, P<0.01), but all within normal range. Vital signs including heart rate, respiratory rate, mean blood pressure showed no differences between the groups (all P>0.05). In GDM group, aortic peak flow velocity were (1.230±0.160) and (1.210±0.220) m/s, left ventricle cardiac output was (0.867±0.196) and (0.859±0.193) L/min, Smith Madigan inotropy index was (0.846±0.180) and (0.823±0.189) W/m2 at one and two hours after birth, respectively, which were significantly higher than those in the control group [aortic peak flow velocity: (1.080±0.130) and (1.090±0.120) m/s; left ventricle cardiac output: (0.754±0.098) and (0.757±0.099)L/min; Smith Madigan inotropy index: (0.746±0.097) and (0.725±0.086) W/m2; t=3.464, 2.265, 2.296, 2.187, 2.263 and 2.202, respectively, all P<0.05]. But no statistically significant differences were found on pulmonary artery peak flow velocity and right cardiac output between the two groups. Cardiac hemodynamics index had no difference between one and two hours within each group (all P>0.05).

Conclusion: The left ventricular contractility and left cardiac work are increased in neonates of gestational diabetes mellitus women with good sugar control during pregnancy.