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Maternal glycemia in women with diabetes affects fetal heart rate
A higher blood glucose level in pregnant women with type 1 diabetes correlates with an accelerated fetal heart rate, according to research in Diabetes Technology & Therapeutics.
Katarzyna Cypryk, MD, PhD, of the Medical University of Lodz, Poland, and colleagues analyzed data from 14 white pregnant women with type 1 diabetes ( 30 weeks gestation; mean age of women, 30.4 years; average gestational week at baseline, 33.5; mean diabetes duration, 14.6 years) who received continuous glucose monitoring (CGM) for at least 48 hours. CGM measurements were performed at least four times per day. Researchers matched fetal electrocardiogram data (measured for at least 20 hours) with CGM data, pairing the data points for analysis. A generalized mixed-effect logistic regression was used to estimate the glucose-dependent risk for fetal heart rate disturbances while accounting for individual factors.
The obstetrics team was masked to CGM recordings during the study period; the endocrinology team was masked to any fetal ECG data, but could adjust insulin treatment depending on glucose levels when needed. During the study period, the mean glucose level within the cohort was 5.64 mmol/L; the mean fetal heart rate was 135 bpm.
Researchers found that higher glucose levels correlated with higher odds of the fetus developing small increases in heart rate (OR = 1.05; 95% CI, 1-1.1). The relationship was not changed after adjusting for mother’s age, BMI, duration of diabetes, gestational week or nighttime measurements, according to researchers. There were no observed instances of long-lasting deceleration during the study.
“In nine patients, [fetal heart rate] showed significant, positive correlation with the time-point-matched maternal glycemia, which consequently held true for an aggregate correlation analysis,” the researchers wrote.
The researchers noted that all women in the cohort had good diabetes control, with a mean HbA1c of 5.95% and blood glucose ranging from 2.22 mmol/L to 10.78 mmol/L during the observation period.
“Our study seems to confirm direct relationship between maternal glycemia and fetal well-being, as it demonstrates that elevated maternal glycemia of mothers with diabetes is associated with accelerations of [fetal heart rate], even in very well-controlled diabetes,” the researchers wrote. – by Regina Schaffer
Disclosure: The researchers report no relevant financial disclosures.