ORIGINAL RESEARCH article
Front. Endocrinol.
Sec. Clinical Diabetes
This article is part of the Research TopicMaternal Nutrition, Gut Microbiota, and Offspring Endocrine DevelopmentView all 4 articles
The Impact of Maternal Gestational Diabetes Mellitus on Cardiac Structural and Functional Parameters in Infants
Provisionally accepted
- Guangdong women and children hospital, Guangzhou, China
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Objective: To retrospectively analyze changes in cardiac structural and functional parameters in infants born to mothers with non-pharmacologically managed gestational diabetes mellitus (GDM), in order to investigate potential cardiovascular developmental risks in GDM offspring beyond overt birth defects and to reveal their age and sex specificity. Methods: The study included infants aged 1–12 months who underwent routine pediatric health examinations, including cardiac ultrasound screening, at Guangdong Women and Children Hospital from January 2018 to December 2023. Participants were divided into a GDM group and a non-GDM control group based on maternal diagnosis. Echocardiography was used to measure cardiac parameters. Multivariable linear and logistic regression models were employed to assess the association between GDM exposure and cardiac parameters, with stratification by infant age and sex. Results: A total of 11,782 mother-infant pairs were enrolled (1,734 in the GDM group; 10,048 in the non-GDM group). After adjusting for confounders, GDM exposure was significantly associated with larger cardiac dimensions, including increased right atrial dimension (RAD) (adjusted mean difference (aMD) = 0.22, 95% CI: 0.09–0.36, P = 0.001), right ventricular outflow tract dimension (aMD = 0.19, 95% CI: 0.08–0.30, P = 0.001), left atrial dimension (LAD) (aMD = 0.17, 95% CI: 0.03–0.32, P = 0.020), left ventricular end-diastolic dimension (aMD = 0.29, 95% CI: 0.11–0.46, P = 0.002), and left ventricular end-systolic dimension (aMD = 0.17, 95% CI: 0.05–0.29, P = 0.006). Age-stratified analysis revealed that in infants <6 months, GDM was associated with increased RAD (aMD = 0.13, 95% CI: 0.01–0.26, P = 0.040) and LAD (aMD = 0.19, 95% CI: 0.04–0.33, P = 0.013). Conversely, in infants aged 6–12 months, GDM was associated with smaller right ventricular dimension (aMD = -0.37, 95% CI: -0.72– -0.01, P = 0.043) and LAD (aMD = -0.48, 95% CI: -0.79– -0.17, P = 0.002). Sex-stratified analysis showed that the associations between GDM and enlarged cardiac structures were significant only in male infants. Furthermore, GDM significantly increased the odds of extreme high RAD (≥95th percentile) in males (OR = 1.30, 95% CI: 1.02–1.65)l. Conclusions: Maternal GDM induces subtle, sex-specific cardiac structural changes in infants, particularly affecting males.
Keywords: Cardiac structural and functional parameters, Gestational diabetes mellitus (GDM), Infant, Pregnancy, sex-specific difference
Received: 09 Sep 2025; Accepted: 10 Feb 2026.
Copyright: © 2026 Deng, Wang, Guo, Guo and Wu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Yong Guo
Jie-Ling Wu
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