Impact of Diabetes on Cardiovascular Function in Pregnant Women

Authors

  • Wissal Jaafar Gynecology Department, Habib Bougatfa Hospital, Bizerte, Tunisia https://orcid.org/0009-0009-1278-5777 (unauthenticated)
  • Syrine Saidane Gynecology Department, Habib Bougatfa Hospital, Bizerte, Tunisia
  • Malak Medemagh Gynecology Department, Habib Bougatfa Hospital, Bizerte, Tunisia
  • Younes El Kharras Cardiology Department, Habib Bougatfa Hospital, Bizerte, Tunisia
  • Wissal Hamdi Cardiology Department, Habib Bougatfa Hospital, Bizerte, Tunisia
  • Omar Haddar Cardiology Department, Habib Bougatfa Hospital, Bizerte, Tunisia
  • Samar Godcha Gynecology Department, Habib Bougatfa Hospital, Bizerte, Tunisia
  • Chaima Khlifi Gynecology Department, Habib Bougatfa Hospital, Bizerte, Tunisia
  • Mehdi Bouassida Gynecology Department, Habib Bougatfa Hospital, Bizerte, Tunisia
  • Khadija Mzoughi Cardiology Department, Habib Bougatfa Hospital, Bizerte, Tunisia
  • Mechaal Mourali Gynecology Department, Habib Bougatfa Hospital, Bizerte, Tunisia

DOI:

https://doi.org/10.62438/tunismed.v104i06.6436

Keywords:

Diabetes, Pregnancy, Echocardiography, Cardiovascular Function

Abstract

Pregnancy induces major cardiovascular adaptations that may be altered in women with diabetes, potentially affecting myocardial performance. This prospective cross-sectional study evaluated the impact of diabetes on cardiovascular function in pregnancy using transthoracic echocardiography.
Seventy-six pregnant women were included, comprising 40 with diabetes and 36 healthy controls. Echocardiographic assessment compared systolic and diastolic parameters between groups. Diabetic women demonstrated a modest but statistically significant reduction in left ventricular
ejection fraction compared with controls (62.4% vs. 64.7%, p = 0.032), although values remained within normal limits. Diastolic function and longitudinal systolic indices, including S′ and TAPSE, were preserved. A subtle tendency toward increased ventricular dimensions was also observed
in the diabetic group. These findings suggest that diabetes in pregnancy is associated with early subclinical alterations in cardiac performance.
Echocardiography emerges as a valuable tool for detecting such changes and could be considered in the routine cardiovascular evaluation of pregnant women with diabetes.

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References

Kepley JM, Bates K, Mohiuddin SS. Physiology, Maternal Changes. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing;

[cité 4 juill 2025]. Disponible sur: http://www.ncbi.nlm.nih.gov/books/NBK539766/

Afari HA, Davis EF, Sarma AA. Echocardiography for the Pregnant Heart. Curr Treat Options Cardiovasc Med. 2021;23(8):55.

Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes— 2021 | Diabetes Care | American Diabetes

Association [Internet]. [cité 4 juill 2025]. Disponible sur: https://diabetesjournals.org/care/article/44/Supplement_1/

S15/30859/2-Classification- and-Diagnosis-of-Diabetes

Habibi N, Mousa A, Tay CT, Khomami MB, Patten RK, Andraweera PH, et al. Maternal metabolic factors and the association with

gestational diabetes: A systematic review and meta-analysis. Diabetes Metab Res Rev. juill 2022;38(5):e3532.

Karkia R, Giacchino T, Shah S, Gough A, Ramadan G, Akolekar R. Gestational Diabetes Mellitus: Association with Maternal and

Neonatal Complications. Medicina (Mex). déc 2023;59(12):2096.

North S, Zinn C, Crofts C. Hyperinsulinemia during pregnancy across varying degrees of glucose tolerance: An examination of the Kraft database. J Obstet Gynaecol Res. mai 2021;47(5):1719-26.

Sonaglioni A, Bordoni T, Naselli A, Nicolosi GL, Grasso E, Bianchi S, et al. Influence of gestational diabetes mellitus on subclinical

myocardial dysfunction during pregnancy: A systematic review and meta-analysis. Eur J Obstet Gynecol Reprod Biol. janv 2024;292:17-

Karagöz A, Bezgin T, Kutlutürk I, Külahçıoğlu S, Tanboğa IH, Güler A, et al. Subclinical left ventricular systolic dysfunction in diabetic

patients and its association with retinopathy: A 2D speckle tracking echocardiography study. Herz. mai 2015;40 Suppl 3:240-6.

Nielsen R, Nørrelund H, Kampmann U, Bøtker HE, Møller N, Wiggers H. Effect of acute hyperglycemia on left ventricular contractile

function in diabetic patients with and without heart failure: two randomized cross-over studies. PloS One. 2013;8(1):e53247.

Giacco F, Brownlee M. Oxidative stress and diabetic complications. Circ Res. 29 oct 2010;107(9):1058-70.

Falcão-Pires I, Leite-Moreira AF. Diabetic cardiomyopathy: understanding the molecular an cellularbasis to progress in

diagnosis and treatment. Heart Fail Rev. mai 2012;17(3):325-44.

Bodiga VL, Eda SR, Bodiga S. Advanced glycation end products: role in pathology of diabetic cardiomyopathy. Heart Fail Rev. janv

;19(1):49-63.

Mohan M, Dihoum A, Mordi IR, Choy AM, Rena G, Lang CC. Left Ventricular Hypertrophy in Diabetic Cardiomyopathy: A Target for

Intervention. Front Cardiovasc Med. 29 sept 2021;8:746382.

von Bibra H, St John Sutton M. Diastolic dysfunction in diabetes and the metabolic syndrome: promising potential for diagnosis and

prognosis. Diabetologia. 2010;53(6):1033-45.

Additional Files

Published

2026-06-21