RESUMO
OBJECTIVE: The aim of this study was to evaluate fetal modified myocardial performance index (mod-MPI) and fetal epicardial fat tissue (EFT) thickness and its association with adverse perinatal outcomes in diabetic pregnant women. PATIENTS AND METHODS: This was a prospective case-control study including 90 gestational diabetes mellitus (GDM) and 45 pregestational diabetes mellitus (PGDM) and 90 healthy pregnant women (control group). Two-dimensional gray-scale and Doppler fetal echocardiography were used to calculate the mod-MPI. EFT thickness was measured in the hypoechogenic area between the myocardium and the visceral pericardium on the right ventricle by distinguishing it from the pericardial fluid by Doppler ultrasound. RESULTS: Both mod-MPI values and EFT thickness were significantly higher in diabetic pregnant women (p<0.001; for both). No significant differences were observed in mod-MPI values and EFT thickness between pregnant women with GDM and PGDM. In addition, there was no significant difference in fetal mod-MPI values and EFT thicknesses among diabetic pregnant women based on their treatment requirements. The receiver operating characteristic (ROC) curve revealed that mod-MPI value (cut-off 0.54, 95% CI: 0.629-0.837, p<0.001, sensitivity 64.6%, specificity 61.7%) and EFT thickness (cut-off 1.85 mm, 95% CI: 0.524-0.750, p=0.014, sensitivity 65.8%, specificity 63.9%) could predict adverse neonatal outcomes in diabetic pregnant women. Multivariate regression analysis revealed that both mod-MPI (p=0.003) and EFT thickness (p=0.008) were independently associated with adverse outcomes. CONCLUSIONS: Fetal mod-MPI values and EFT thickness increase in pregnancies complicated by diabetes, and these measurements may serve as valuable predictors of adverse perinatal outcomes.