Correlation Study On Myocardial Development Of Full-term Neonates Of Mothers With Gestational Diabetes Mellitus

Objective:To study the outcome of myocardial development in full-term neonates whose pregnant mothers suffer from gestational diabetes mellitus(GDM),and to explore the evaluation value of cord blood angiopoietin-like protein 7(Angptl7)level on myocardial development,and to find newborns who can early predict the delivery of GDM mothers.The reference index of myocardial hypertrophy in children.Methods:By using a single-center,controlled research method,among the 3390 live births born in the obstetrics department of Zhongshan City People’s Hospital from October1,2021 to November 30,2022,pregnant women who met the inclusion criteria except the exclusion criteria 46 full-term newborns with gestational diabetes were randomly selected as the GDM group,and 46 healthy full-term newborns whose mothers did not suffer from gestational diabetes were randomly selected at a ratio of 1:1 as the normal control group.According to the prenatal blood glucose control of pregnant mothers,newborns in GDM group were further divided into unsatisfactory maternal blood glucose control group(GDM-A group)and pregnant mothers satisfactory blood glucose control group(GDM-B group);Whether combined with cardiac hypertrophy,further divided into neonatal cardiac hypertrophy group(H group)and neonatal non-cardiac hypertrophy group(N-H group).The clinical data of pregnant mothers and newborns were collected,and the level of Angptl7 and N-terminal pro-B-type natriuretic peptide(NT-pro BNP)in cord blood of newborns were measured by enzyme-linked immunoassay,and the thickness of interventricular septum(IVS)was measured by echocardiography,left ventricular posterior wall(LVPW)thickness and other data,and compared the incidence of neonatal myocardial hypertrophy,umbilical cord blood Angptl7 level,NT-pro BNP level,IVS,the ratio of interventricular septal thickness to left ventricular posterior wall(IVS/LVPW)and interventricular septal thickness/birth weight ratio(IVS/BW)between groups,and analyze the correlation between cord blood Angptl7 and NT-pro BNP,IVS and IVS/BW ratio,so as to explore the effect of cord blood Angptl7 level on patients with gestational diabetes mellitus,especially prenatal blood glucose evaluative value for the effects on myocardial development in full-term neonates with suboptimal control of maternal deliveries.Results:1.The incidence of myocardial hypertrophy in newborns in the GDM group was higher than that in the normal control group,and the difference between the groups was statistically significant(P <0.05).In the GDM group,the incidence of myocardial hypertrophy in newborns in the group with unsatisfactory maternal blood sugar control was higher than that in the normal group In the control group,the difference between the groups was statistically significant(P <0.05).2.The level of Angptl7 and NT-pro BNP in the cord blood of the GDM group was higher than that of the normal control group,and the difference between the groups was statistically significant(P <0.05);3.There were statistically significant differences in the levels of cord blood Angptl7 between the unsatisfactory maternal blood glucose control group,the satisfactory maternal blood glucose control group,and the normal control group.Pregnant mothers with unsatisfactory blood sugar control group and pregnant mothers with satisfactory blood sugar control group were significantly higher than those in the normal control group(P <0.05).4.There was no significant difference between the GDM Group and the control group in the ventricular septal thickness(IVS),the ratio of IVS/LVPW and the ratio of IVS/BW(P > 0.05).There were significant differences in IVS/LVPW among the three groups: unsatisfied group,satisfied group and normal control group.The unsatisfactory maternal blood glucose control group and the pregnant maternal blood glucose control satisfactory group were higher than the normal control group(P<0.05).There was no significant difference in IVS and IVS/BW among the three groups(P > 0.05).5.Cord blood Angptl7 level in GDM group was positively correlated with IVS、IVS/BW ratio and NT-pro BNP(correlation coefficients were 0.569,0.370,0.493,P<0.05).Conclusion:1.Full-term neonates with gestational diabetes mellitus,especially mothers with poor blood sugar control,are prone to cardiac hypertrophy,accompanied by elevated levels of Angptl7 in cord blood.2.Cord blood Angptl7 level is closely related to prenatal blood sugar control of pregnant women with GDM,and positively correlated with cord blood NT-pro BNP and neonatal septal thickness.3.The elevated level of NT-pro BNP in umbilical cord blood of newborns of GDM mothers may reflect the potential damage of cardiac function in newborns of mothers with gestational diabetes mellitus.