FETAL CARDIAC FUNCTION AND DEVELOPMENT IN GESTATIONAL DIABETES: CLINICAL EVALUATION AND MANAGEMENT STRATEGIES

Abstract

Gestational diabetes (GD) represents a significant challenge to maternal and fetal health. Maternal hyperglycemia, characteristic of GD, can trigger a series of complications, including changes in fetal development and cardiac dysfunction. Fetal cardiac dysfunction, in turn, can increase the risk of perinatal morbidity and mortality and the development of cardiovascular diseases in adulthood. Understanding the mechanisms by which GD affects fetal cardiac function and cardiovascular development is critical to developing effective management strategies. Objective: The objective of this systematic literature review was to identify and synthesize the available scientific evidence on the relationship between gestational diabetes, fetal heart function and cardiovascular development, with the aim of providing support for clinical practice and future research. Methodology: A systematic review of the literature was carried out, following the recommendations of the PRISMA statement, with the aim of identifying studies that investigated the relationship between gestational diabetes and fetal heart function. The PubMed, Scielo and Web of Science databases were used, with the following descriptors: “gestational diabetes”, “fetal heart function”, “fetal development”, “fetal echocardiography” and “fetal complications”. The search was limited to articles published in the last 10 years. The inclusion criteria were: original studies, published in Portuguese or English, that evaluated fetal cardiac function in pregnant women diagnosed with gestational diabetes. Exclusion criteria were: systematic reviews, meta-analyses, case studies and studies that did not evaluate fetal cardiac function. Results: The results of the review demonstrated that gestational diabetes is associated with an increased risk of fetal cardiac dysfunction, characterized by changes in the structure and function of the fetal heart, such as left ventricular hypertrophy, atrial dilation and changes in cardiac output. Furthermore, GD can lead to changes in fetal vascular development, with an increased risk of intrauterine growth restriction and perinatal complications. Conclusion: Gestational diabetes has a significant impact on fetal heart function and cardiovascular development. Chronic maternal hyperglycemia can trigger a series of metabolic and hemodynamic changes that compromise the normal development of the fetal heart. Early diagnosis of GD and strict control of maternal blood glucose levels are essential to minimize risks to the fetus. However, more research is needed to elucidate the pathophysiological mechanisms involved and to develop new prevention and treatment strategies.