{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T12:08:52Z","timestamp":1784203732185,"version":"3.55.0"},"reference-count":41,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2017,5,4]],"date-time":"2017-05-04T00:00:00Z","timestamp":1493856000000},"content-version":"vor","delay-in-days":3,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp;amp; Gyne"],"published-print":{"date-parts":[[2017,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Experimental evidence suggests that changes in the fetal myocardium result from intrauterine effects of maternal diabetes mellitus and obesity. The aim of this study was to assess fetal cardiac function using two\u2010dimensional speckle\u2010tracking echocardiography to determine the effects of maternal diabetes and obesity on the fetal myocardium.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Comparative cross\u2010sectional evaluation of myocardial function in fetuses of mothers with diabetes mellitus (<jats:styled-content style=\"fixed-case\">FDM<\/jats:styled-content>) or obesity (<jats:styled-content style=\"fixed-case\">FO<\/jats:styled-content>) and normal gestational age\u2010matched control fetuses (<jats:styled-content style=\"fixed-case\">FC<\/jats:styled-content>) was performed using two\u2010dimensional speckle\u2010tracking echocardiography at two centers.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In total, 178 fetuses (82 <jats:styled-content style=\"fixed-case\">FDM<\/jats:styled-content>, 26 <jats:styled-content style=\"fixed-case\">FO<\/jats:styled-content> and 70 <jats:styled-content style=\"fixed-case\">FC<\/jats:styled-content>) met the enrolment criteria. Mean gestational age at assessment was similar among groups: 25.3\u2009\u00b1\u20095.1\u2009weeks for <jats:styled-content style=\"fixed-case\">FDM<\/jats:styled-content>, 25.0\u2009\u00b1\u20094.6\u2009weeks for <jats:styled-content style=\"fixed-case\">FO<\/jats:styled-content> and 25.1\u2009\u00b1\u20094.9\u2009weeks for <jats:styled-content style=\"fixed-case\">FC<\/jats:styled-content>. Mean maternal body mass index was significantly higher in <jats:styled-content style=\"fixed-case\">FDM<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">FO<\/jats:styled-content> groups compared with the <jats:styled-content style=\"fixed-case\">FC<\/jats:styled-content> group. Statistically significant differences in fetal cardiac function were detected between <jats:styled-content style=\"fixed-case\">FDM<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">FC<\/jats:styled-content> for global longitudinal strain (mean\u2009\u00b1\u2009<jats:styled-content style=\"fixed-case\">SD<\/jats:styled-content>, \u201321.4\u2009\u00b1\u20096.5% <jats:italic>vs<\/jats:italic> \u201327.0\u2009\u00b1\u20095.2%; <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001), global circumferential strain (mean\u2009\u00b1\u2009<jats:styled-content style=\"fixed-case\">SD<\/jats:styled-content>, \u201322.6\u2009\u00b1\u20096.5% <jats:italic>vs<\/jats:italic> \u201326.2\u2009\u00b1\u20096.8%; <jats:italic>P<\/jats:italic>\u2009=\u20090.002), average longitudinal systolic strain rate (median, \u20131.4 (interquartile range (<jats:styled-content style=\"fixed-case\">IQR<\/jats:styled-content>), \u20131.7 to \u20131.1)\/s <jats:italic>vs<\/jats:italic> \u20131.6 (<jats:styled-content style=\"fixed-case\">IQR<\/jats:styled-content>, \u20132.0 to \u20131.4)\/s; <jats:italic>P<\/jats:italic>\u2009=\u20090.001) and average circumferential systolic strain rate (median, \u20131.4 (<jats:styled-content style=\"fixed-case\">IQR<\/jats:styled-content>, \u20131.9 to \u20131.1)\/s <jats:italic>vs<\/jats:italic> \u20131.6 (<jats:styled-content style=\"fixed-case\">IQR<\/jats:styled-content>, \u20132.1 to \u20131.3)\/s; <jats:italic>P<\/jats:italic>\u2009=\u20090.006). Cases of non\u2010obese <jats:styled-content style=\"fixed-case\">FDM<\/jats:styled-content> also had abnormal strain parameters compared with <jats:styled-content style=\"fixed-case\">FC<\/jats:styled-content>. Global longitudinal strain (mean\u2009\u00b1\u2009<jats:styled-content style=\"fixed-case\">SD<\/jats:styled-content>, \u201321.1\u2009\u00b1\u20097.5%) and average circumferential  systolic strain rate (median, \u20131.3 (<jats:styled-content style=\"fixed-case\">IQR<\/jats:styled-content>, \u20131.8 to \u20131.1)\/s) were significantly lower in <jats:styled-content style=\"fixed-case\">FO<\/jats:styled-content> compared with <jats:styled-content style=\"fixed-case\">FC<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Unfavorable changes occur in the fetal myocardium in response to both maternal diabetes mellitus and obesity. The long\u2010term prognostic implications of these changes require further study. Copyright \u00a9 2016 ISUOG. 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