Impact of Diabetes on Cardiovascular Function in Pregnant Women

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Published Jun 21, 2026
https://doi.org/10.62438/tunismed.v104i06.6436
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Vol. 104 No. 06 (2026): Tunis Med Jun 2026

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Wissal Jaafar
Gynecology Department, Habib Bougatfa Hospital, Bizerte, Tunisia
https://orcid.org/0009-0009-1278-5777
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

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.

Keywords:

Diabetes, Pregnancy, Echocardiography, Cardiovascular Function

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References

  1. Kepley JM, Bates K, Mohiuddin SS. Physiology, Maternal Changes. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing;
  2. [cité 4 juill 2025]. Disponible sur: http://www.ncbi.nlm.nih.gov/books/NBK539766/
  3. Afari HA, Davis EF, Sarma AA. Echocardiography for the Pregnant Heart. Curr Treat Options Cardiovasc Med. 2021;23(8):55.
  4. Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes— 2021 | Diabetes Care | American Diabetes
  5. Association [Internet]. [cité 4 juill 2025]. Disponible sur: https://diabetesjournals.org/care/article/44/Supplement_1/
  6. S15/30859/2-Classification- and-Diagnosis-of-Diabetes
  7. Habibi N, Mousa A, Tay CT, Khomami MB, Patten RK, Andraweera PH, et al. Maternal metabolic factors and the association with
  8. gestational diabetes: A systematic review and meta-analysis. Diabetes Metab Res Rev. juill 2022;38(5):e3532.
  9. Karkia R, Giacchino T, Shah S, Gough A, Ramadan G, Akolekar R. Gestational Diabetes Mellitus: Association with Maternal and
  10. Neonatal Complications. Medicina (Mex). déc 2023;59(12):2096.
  11. 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.
  12. Sonaglioni A, Bordoni T, Naselli A, Nicolosi GL, Grasso E, Bianchi S, et al. Influence of gestational diabetes mellitus on subclinical
  13. myocardial dysfunction during pregnancy: A systematic review and meta-analysis. Eur J Obstet Gynecol Reprod Biol. janv 2024;292:17-
  14. Karagöz A, Bezgin T, Kutlutürk I, Külahçıoğlu S, Tanboğa IH, Güler A, et al. Subclinical left ventricular systolic dysfunction in diabetic
  15. patients and its association with retinopathy: A 2D speckle tracking echocardiography study. Herz. mai 2015;40 Suppl 3:240-6.
  16. Nielsen R, Nørrelund H, Kampmann U, Bøtker HE, Møller N, Wiggers H. Effect of acute hyperglycemia on left ventricular contractile
  17. function in diabetic patients with and without heart failure: two randomized cross-over studies. PloS One. 2013;8(1):e53247.
  18. Giacco F, Brownlee M. Oxidative stress and diabetic complications. Circ Res. 29 oct 2010;107(9):1058-70.
  19. Falcão-Pires I, Leite-Moreira AF. Diabetic cardiomyopathy: understanding the molecular an cellularbasis to progress in
  20. diagnosis and treatment. Heart Fail Rev. mai 2012;17(3):325-44.
  21. Bodiga VL, Eda SR, Bodiga S. Advanced glycation end products: role in pathology of diabetic cardiomyopathy. Heart Fail Rev. janv
  22. ;19(1):49-63.
  23. Mohan M, Dihoum A, Mordi IR, Choy AM, Rena G, Lang CC. Left Ventricular Hypertrophy in Diabetic Cardiomyopathy: A Target for
  24. Intervention. Front Cardiovasc Med. 29 sept 2021;8:746382.
  25. von Bibra H, St John Sutton M. Diastolic dysfunction in diabetes and the metabolic syndrome: promising potential for diagnosis and
  26. prognosis. Diabetologia. 2010;53(6):1033-45.