The Impact of Maternal Obesity Is More Deleterious Regarding in trauterine Cardiac Adaptation Than Gestational Diabetes

Abstract

Background: Increasing observations show that obesity and its associated cardiovascular conditions may start during fetal development. This intrauterine adaptation may be attributable to different maternal factors such as diet and metabolic control. The objective of the present study was to determine if, in the presence of well controlled gestational diabetes, maternal anthropometric parameters and/or environmental factors are modulating fetal anthropometric and/or cardiac parameters. Methods: Sixty-nine (69) fetuses and their well-controlled gestational diabetic mothers were compared, retrospectively, to a control group of 12 normal mothers and fetuses. Fetal and maternal anthropometric and fetal parameters, as well as environmental factors were assessed and compared based on the presence of gestational diabetes. Glycated hemoglobin level (HbA1c) was used as a marker of good metabolic control. Echocardiographic variables, including the Tei index, were measured between the 19th and 25th week of gestation. Results: The two groups were comparable based on age. The HbA1c for the GDM group was of 6.4%. However, mothers with gestational diabetes were heavier than controls (over 25kg difference). Although results were within normal values, differences (p