Pediatric Cardiology

, Volume 16, Issue 1, pp 24–27 | Cite as

Altered diastolic function in infants of mothers with gestational diabetes: No relation to macrosomia

  • S. Mehta
  • I. Nuamah
  • S. Kalhan
Original Articles


In a previous study, asymptomatic infants of mothers with gestational diabetes (IGDMs) were observed to have altered left ventricular (LV) filling. In the present study, we reanalyzed the data to examine whether the observed abnormalities were related to maternal diabetes or due to the greater preponderance of macrosomic infants (32%) in the gestational diabetes group. No echocardiographic (systolic or diastolic) differences were observed when the data were compared in 16 large-for-gestational-age (LGA) and 24 appropriate-for-gestational-age (AGA) infants among IGDM. Comparison of 16 LGA IGDM and 17 LGA infants of control mothers revealed lower LV size during diastole and systole in the IGDM. The present analysis suggests that the cardiac alterations in the IGDMs are not due to the preponderance of macrosomia but, rather, the consequence of altered in utero metabolic environment.

Key words

Diastolic function Macrosomia Gestational Diabetes 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Bard H, Fouron JC, Muylder X De, Ducharme G, Lafond JS (1986) Myocardial function and hemoglobin oxygen affinity during hyperglycemia in the fetal lamb.J Clin Invest 78:191–195PubMedGoogle Scholar
  2. 2.
    Becerra JE, Khoury MJ, Cordero JF, Erickson JD (1990) Diabetes mellitus during pregnancy and the risks for specific birth defects: a population based case-control study.Pediatrics 85:1–9PubMedGoogle Scholar
  3. 3.
    Gutgesell HP, Speer ME, Rosenberg HS (1980) Characterization of the cardiomyopathy in infants of diabetic mothers.Circulation 61:441–450PubMedGoogle Scholar
  4. 4.
    Kalhan SC, Schwartz R, Adam PAJ (1975) Placental barrier to human insulin I-125 in insulin-dependent diabetic mothers.J Clin Endocrinol Metab 40:139–142PubMedGoogle Scholar
  5. 5.
    Mace S, Hirschfeld SS, Riggs T, Fanaroff AA, Merkatz IR (1979) Echocardiographic abnormalities in infants of diabetic mothers.J Pediatr 95:1013–1019PubMedGoogle Scholar
  6. 6.
    Mehta S, Nuamah I, Kalhan S (1991) Altered diastolic function in asymptomatic infants of mothers with gestational diabetes.Diabetes 40(Suppl 2):56–60PubMedGoogle Scholar
  7. 7.
    Miller HC, Wilson HM (1943) Macrosomia, cardiac hypertrophy, erythroblastosis and hyperplasia of the islets of Langerhans in infants born to diabetic mothers.J Pediatr 23:251–266Google Scholar
  8. 8.
    Philipps AF, Dubin JW, Raye JR (1981) Fetal metabolic response to endogenous insulin release.Am J Obstet Gynecol 139:441–445PubMedGoogle Scholar
  9. 9.
    Philipson EH, Kalhan SC, Rosen MG, et al (1985) Gestational diabetes mellitus: is further improvement necessary?Diabetes 34(Suppl 2):55–60PubMedGoogle Scholar
  10. 10.
    Reller MD, Tsang RC, Meyer RA, Braun CP (1985) Relationship of prospective diabetes control in pregnancy to neonatal cardiorespiratory function.J Pediatr 106:86–90PubMedGoogle Scholar
  11. 11.
    Riggs TW, Rodriguez R, Snider AR, Batton D (1989) Doppler echocardiographic evaluation of right and left ventricular diastolic function in normal neonates.J Am Coll Cardiol 13:700–705PubMedGoogle Scholar
  12. 12.
    Rizzo G, Arduini D, Romanini C (1991) Cardiac function on fetuses of type I diabetic mothers.Am J Obstet Gynecol 164:837–843PubMedGoogle Scholar
  13. 13.
    Stonestreet BS (1990) Effects of prolonged fetal hyperinsulinemia on plasma catecholamines, circulation and oxygen metabolism in utero.Dev Pharmacol Ther 15:35–44PubMedGoogle Scholar
  14. 14.
    Weber HS, Copel JA, Reece EA, Green G, Klienman CS (1991) Cardiac growth in fetuses of diabetic mothers with good metabolic control.J Pediatr 118:103–107PubMedGoogle Scholar
  15. 15.
    Wolfe RR, Way GL (1977) Cardiomyopathies in infants of diabetic mothers.Johns Hopkins Med J 140:177–180PubMedGoogle Scholar

Copyright information

© Springer-Verlag New York Inc. 1995

Authors and Affiliations

  • S. Mehta
    • 1
  • I. Nuamah
    • 1
  • S. Kalhan
    • 1
  1. 1.Department of PediatricsMetroHealth Medical CenterClevelandUSA

Personalised recommendations