The correlation of fetal cardiac function with gestational diabetes mellitus (GDM) and oxidative stress levels

Abstract

<jats:title>Abstract</jats:title><jats:sec id="j_jpm-2019-0457_s_999_w2aab3b7c20b1b6b1aab1c16b1Aa"><jats:title>Background</jats:title><jats:p>The primary objective of this study was to compare the fetal cardiac performance index (Tei index) between the fetuses of gestational diabetes mellitus (GDM) mothers and non-GDM mothers; and the secondary objective was to compare various other parameters of fetal cardiac function as well as maternal oxidative stress levels between the groups of GDM and non-GDM mothers.</jats:p></jats:sec><jats:sec id="j_jpm-2019-0457_s_998_w2aab3b7c20b1b6b1aab1c16b2Aa"><jats:title>Methods</jats:title><jats:p>A cross-sectional study was conducted on pregnant women at 24–28 weeks of gestation. All of the participants underwent 100 g, 3-h oral glucose tolerance test (OGTT) as a diagnostic test for GDM and were categorized as non-GDM and GDM group. All participants had fetal echocardiography performed for cardiac function, and then maternal blood samples were collected for biomarker measurements.</jats:p></jats:sec><jats:sec id="j_jpm-2019-0457_s_997_w2aab3b7c20b1b6b1aab1c16b3Aa"><jats:title>Results</jats:title><jats:p>A total of 80 pregnant women, including 43 in the GDM group and 37 in the non-GDM group, were included in the study. The maternal serum 8-isoprostane (8IsoP), tumor necrosis factor-α (TNF-α) and interleukin (IL)-10 levels were significantly higher in the GDM group than those in the non-GDM group (P: 0.028, P: 0.019 and P: 0.031, respectively). The fetal cardiac function parameters were not significantly different between the two groups. Regardless of the GDM status, the fetuses with high levels of oxidative stress (8Isop ≥1000 pg/mg protein) had a significantly higher rate of impaired shortening fraction (SF) of the left ventricle (P: 0.001).</jats:p></jats:sec><jats:sec id="j_jpm-2019-0457_s_996_w2aab3b7c20b1b6b1aab1c16b4Aa"><jats:title>Conclusion</jats:title><jats:p>GDM is significantly associated with an increase in the oxidative stress process, and a high level of oxidative stress was significantly associated with left ventricular (LV) function impairment. Though a correlation between GDM and fetal cardiac function impairment was not clearly demonstrated in this study, this study suggests that GDM patients with a high level of oxidative stress should be evaluated for fetal cardiac function.</jats:p></jats:sec>

The effect of gestational diabetes mellitus on fetal right heart growth in late‐term pregnancy: A prospective study

“…Particularly, we observed significant differences in right heart indicators, such as the RV, TAPSE, and s'. These results suggest that GDM may have a profound impact on the development of the fetal right heart during late‐term pregnancy, which is consistent with the findings of recent clinical studies 22,28 …”

“…These results suggest that GDM may have a profound impact on the development of the fetal right heart during late-term pregnancy, which is consistent with the findings of recent clinical studies. 22,28…”

Markers of Oxidative Stress in Obstetrics and Gynaecology—A Systematic Literature Review

“…The rest of parameters were oxidative stress index-OSI ( n = 3), GST ( n = 2), GR ( n = 2), uric acid ( n = 2), xanthine oxidase ( n = 2), TOS ( n = 1), TNF-α ( n = 1), IL-10 ( n = 1), paraoxonase (PON-1) ( n = 1), inactivation of aldehyde dehydrogenase ( n = 1), irisin ( n = 1), bilirubin ( n = 1), 8-OHdG ( n = 1), sulfhydryl groups ( n = 1), plasma and erythrocyte carbonyl proteins ( n = 1), heme oxygenase 1 ( n = 1), nuclear factor erythroid 2-related factor-2 ( n = 1), quinone oxidoreductase (NQO1) ( n = 1), aldo-keto reductase family 1 member c1 (AKR1C1) ( n = 1), 8-iso-prostaglandin F2α (1), ceruloplasmin (1), hs-CRP ( n = 1), transferrin ( n = 1), advanced oxidative protein products (AOPPs) ( n = 1), protein carbonyl (PCO) ( n = 1), GPx3 ( n = 1), protein (P-SH) ( n = 1), total nitrite ( n = 1), non-protein thiol (NP-SH) ( n = 1), total thiol ( n = 1), non-protein thiol (NP-SH) ( n = 1), P66Shc mRNA ( n = 1), Drp1 mRNA ( n = 1), protein ROS ( n = 1), antioxidant enzymes and gene expression for mitochondrial function: ND2, TFAM, PGC1α, and NDUFB9 ( n = 1) [ 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 ].…”

Educational Review: The Impact of Perinatal Oxidative Stress on the Developing Kidney

“…The well-controlled oxidative stress in the placenta plays a role in modulating angiogenesis, immunoregulation, cytotrophoblast invasion, vasoactive function, cellular proliferation, necrosis and apoptosis (18). Disruption of this balance induces inflammatory responses and cellular damage on the developing fetus with teratogenic and long-term consequences, depending on the timing of these events (19)(20)(21)(22). Defective deep placentation can lead to uteroplacental insufficiency and chronic placental hypoxia/ischemia, resulting in the adverse outcomes of pregnancy with oxidative stress, especially recurrent pregnancy loss, hypertensive disorders of pregnancy, fetal growth restriction (FGR), gestational diabetes mellitus (GDM) and preterm birth (10,23).…”