{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T17:15:07Z","timestamp":1783790107259,"version":"3.55.0"},"reference-count":20,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T00:00:00Z","timestamp":1783728000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T00:00:00Z","timestamp":1783728000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp;amp; Obste"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study evaluates second\u2010trimester fetal cardiac morphometric parameters in gestational diabetes mellitus (GDM) pregnancies compared with healthy controls, assesses their discriminative ability for GDM and composite adverse perinatal outcome (CAPO), and identifies morphometric parameters associated with CAPO.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A total of 180 singleton pregnancies were included: 90 women with GDM (30 insulin\u2010treated and 60 diet\u2010controlled) and 90 gestational\u2010age\u2010matched controls. Fetal echocardiographic assessments were performed at 20\u201322 gestational weeks.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Gestational diabetes mellitus fetuses exhibited a significantly lower right ventricular sphericity index, greater interventricular septal (IVS) thickness, a lower cardiac sphericity index, and a greater cardiac transverse diameter compared with controls. Receiver operating characteristic analysis identified the right ventricular sphericity index as the best discriminator for GDM (area under the curve [AUC] 0.808; cut\u2010off \u22641.65; sensitivity 74.4%, specificity 77.8%), while IVS thickness exhibited the highest discriminative performance for CAPO (AUC 0.810; cut\u2010off &gt;2.09\u2009mm; sensitivity 84.6%, specificity 76.2%). In multivariable analysis, right ventricular sphericity index below Q1 (adjusted odds ratio [OR] 7.71;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001), cardiac sphericity index below Q1 (adjusted OR 3.9;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.004), and pre\u2010pregnancy body mass index &gt;30\u2009kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      (adjusted OR 5.3;\n                      <jats:italic>P\u2009&lt;<\/jats:italic>\n                      \u20090.001) were independent discriminating factors of GDM. IVS thickness above Q3 (&gt;2.18\u2009mm) was identified as an independent discriminating factor of CAPO (adjusted OR 3.41;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The right ventricular sphericity index and IVS thickness are the most clinically useful parameters for discriminator GDM and CAPO, respectively. These findings are hypothesis\u2010generating and require prospective, multicenter validation before integration into clinical practice. Targeted second\u2010trimester cardiac morphometric assessment might complement existing GDM monitoring strategies in future research settings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ijgo.71185","type":"journal-article","created":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T16:49:12Z","timestamp":1783788552000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Second\u2010trimester fetal cardiac remodeling in gestational diabetes: Discriminative value of cardiac morphometry for gestational diabetes and adverse perinatal outcomes"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9050-2041","authenticated-orcid":false,"given":"Deniz","family":"Oluklu","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, Division of Perinatology, Sincan Training and Research Hospital Health Sciences University  Ankara Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-7707-7574","authenticated-orcid":false,"given":"Fatma","family":"Oluklu","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Turkish Ministry of Health Ankara City Hospital Health Sciences University  Ankara Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,11]]},"reference":[{"issue":"3","key":"e_1_2_12_2_1","doi-asserted-by":"crossref","first-page":"341","DOI":"10.1016\/j.diabres.2013.10.012","article-title":"Diagnostic criteria and classification of hyperglycaemia first detected in pregnancy: a World Health Organization guideline","volume":"103","year":"2014","journal-title":"Diabetes Res Clin Pract"},{"key":"e_1_2_12_3_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.diabres.2021.109050","article-title":"IDF diabetes atlas: estimation of global and regional gestational diabetes mellitus prevalence for 2021 by International Association of Diabetes in pregnancy study Group's criteria","volume":"183","author":"Wang H","year":"2022","journal-title":"Diabetes Res Clin Pract"},{"issue":"1","key":"e_1_2_12_4_1","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1038\/s41572-019-0098-8","article-title":"Gestational diabetes mellitus","volume":"5","author":"McIntyre HD","year":"2019","journal-title":"Nat Rev Dis Primers"},{"issue":"2","key":"e_1_2_12_5_1","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1016\/j.ajog.2023.08.011","article-title":"Gestational diabetes mellitus and adverse maternal and perinatal outcomes in twin and singleton pregnancies: a systematic review and meta\u2010analysis","volume":"230","author":"Greco E","year":"2024","journal-title":"Am J Obstet Gynecol"},{"key":"e_1_2_12_6_1","doi-asserted-by":"crossref","DOI":"10.1136\/bmj-2021-067946","article-title":"Gestational diabetes mellitus and adverse pregnancy outcomes: systematic review and meta\u2010analysis","volume":"377","author":"Ye W","year":"2022","journal-title":"BMJ"},{"issue":"5","key":"e_1_2_12_7_1","doi-asserted-by":"crossref","first-page":"387","DOI":"10.1159\/000494838","article-title":"Nomograms of fetal cardiac dimensions at 18\u201041\u2009weeks of gestation","volume":"47","author":"Garc\u00eda\u2010Otero L","year":"2020","journal-title":"Fetal Diagn Ther"},{"issue":"6","key":"e_1_2_12_8_1","doi-asserted-by":"crossref","first-page":"1023","DOI":"10.1080\/14767058.2022.2035712","article-title":"Fetal cardiac morphology and geometry in pregnancies with class A1 and A2 gestational diabetes mellitus","volume":"35","author":"Turgut E","year":"2022","journal-title":"J Matern Fetal Neonatal Med"},{"issue":"4","key":"e_1_2_12_9_1","doi-asserted-by":"crossref","first-page":"539","DOI":"10.1002\/uog.22163","article-title":"Effect of maternal diabetes on fetal heart function on echocardiography: systematic review and meta\u2010analysis","volume":"57","author":"Depla AL","year":"2021","journal-title":"Ultrasound Obstet Gynecol"},{"key":"e_1_2_12_10_1","doi-asserted-by":"crossref","DOI":"10.3389\/fendo.2025.1474643","article-title":"Influence of gestational diabetes mellitus on the cardiovascular system and its underlying mechanisms","volume":"16","author":"Zhang Z","year":"2025","journal-title":"Front Endocrinol (Lausanne)"},{"issue":"6","key":"e_1_2_12_11_1","doi-asserted-by":"crossref","first-page":"2972","DOI":"10.3390\/app16062972","article-title":"Practical Guide to Fetal Functional Cardiac Assessment","volume":"16","author":"Erenbourg A","year":"2026","journal-title":"Appl Sci"},{"issue":"3","key":"e_1_2_12_12_1","doi-asserted-by":"crossref","first-page":"388","DOI":"10.1002\/uog.23127","article-title":"Reference ranges for fetal cardiac, ventricular and atrial relative size, sphericity, ventricular dominance, wall asymmetry and relative wall thickness from 18 to 41 gestational weeks","volume":"58","author":"Garc\u00eda\u2010Otero L","year":"2021","journal-title":"Ultrasound Obstet Gynecol"},{"issue":"2","key":"e_1_2_12_13_1","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1515\/jpm-2023-0306","article-title":"The evaluation of fetal interventricular septum with M\u2010mode and spectral tissue Doppler imaging in gestational diabetes mellitus: a case\u2010control study","volume":"52","author":"Oluklu D","year":"2024","journal-title":"J Perinat Med"},{"issue":"2","key":"e_1_2_12_14_1","doi-asserted-by":"crossref","first-page":"175","DOI":"10.3758\/BF03193146","article-title":"G*power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences","volume":"39","author":"Faul F","year":"2007","journal-title":"Behav Res Methods"},{"issue":"1","key":"e_1_2_12_15_1","doi-asserted-by":"crossref","first-page":"1351","DOI":"10.1186\/s12884-025-08491-2","article-title":"First\u2010trimester atherogenic index of plasma and triglyceride\u2010glucose indices in pregestational diabetes mellitus: associations with adverse pregnancy outcomes","volume":"25","author":"Yalcin SE","year":"2025","journal-title":"BMC Pregnancy Childbirth"},{"issue":"13","key":"e_1_2_12_16_1","doi-asserted-by":"crossref","first-page":"1301","DOI":"10.1002\/pd.4471","article-title":"Use of the myocardial performance index as a prognostic indicator of adverse fetal outcome in poorly controlled gestational diabetic pregnancies","volume":"34","author":"Bhorat IE","year":"2014","journal-title":"Prenat Diagn"},{"issue":"1","key":"e_1_2_12_17_1","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1016\/j.ejogrb.2010.08.002","article-title":"Fetal myocardial morphological and functional changes associated with well\u2010controlled gestational diabetes","volume":"154","author":"Garcia\u2010Flores J","year":"2011","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"issue":"1","key":"e_1_2_12_18_1","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1002\/jum.15994","article-title":"Evaluation of fetal cardiac function in maternal gestational diabetes mellitus by speckle\u2010tracking echocardiography","volume":"42","author":"Huang P","year":"2023","journal-title":"J Ultrasound Med"},{"issue":"9","key":"e_1_2_12_19_1","doi-asserted-by":"crossref","DOI":"10.3390\/diagnostics12092053","article-title":"Evaluation of fetal cardiac geometry and contractility in gestational diabetes mellitus by two\u2010dimensional speckle\u2010tracking technology","volume":"12","author":"Giread\u0103 R","year":"2022","journal-title":"Diagnostics (Basel)"},{"issue":"5","key":"e_1_2_12_20_1","doi-asserted-by":"crossref","first-page":"634","DOI":"10.1002\/uog.20187","article-title":"Perinatal changes in fetal cardiac geometry and function in diabetic pregnancy at term","volume":"54","author":"Patey O","year":"2019","journal-title":"Ultrasound Obstet Gynecol"},{"issue":"8","key":"e_1_2_12_21_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.bbadis.2023.166834","article-title":"Fetoplacental endothelial dysfunction in gestational diabetes mellitus and maternal obesity: a potential threat for programming cardiovascular disease","volume":"1869","author":"Diniz MS","year":"2023","journal-title":"Biochim Biophys Acta Mol basis Dis"}],"container-title":["International Journal of Gynecology &amp; Obstetrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ijgo.71185","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ijgo.71185","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ijgo.71185","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T16:49:15Z","timestamp":1783788555000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1002\/ijgo.71185"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,11]]},"references-count":20,"alternative-id":["10.1002\/ijgo.71185"],"URL":"https:\/\/doi.org\/10.1002\/ijgo.71185","archive":["Portico"],"relation":{},"ISSN":["0020-7292","1879-3479"],"issn-type":[{"value":"0020-7292","type":"print"},{"value":"1879-3479","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,11]]},"assertion":[{"value":"2026-04-29","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-14","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-11","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"ijgo.71185"}}