Blood flow study on pregnant women with diabetes shows reduced brain circulation

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A study looking at pregnant women with diabetes and blood flow to their unborn baby has shown there is greater circulation to the placenta instead of the brain.
These findings might explain why babies born to women with diabetes are normally bigger.
It is already known that diabetes can affect fetal organs, but researchers wanted to investigate further to see if there was potentially any long-term damage to the child.
A total of 14 women with either type 1 diabetes or type 2 diabetes and 16 expectant women without the condition took part in the research led by an American team.
Lead author Dr Aparna Kulkarni, a pediatric cardiologist from the Bronx-Lebanon Hospital Centre in New York, said: “We know that maternal diabetes mellitus affects the fetal organs.
“Babies born to mothers with diabetes are sometimes bigger, especially if the diabetes is uncontrolled, and the placenta is larger. There is data to suggest that some other organs such as the pancreas and the kidneys in the fetus might be affected.”
Several methods were used to control blood sugar levels in the diabetes group: nine women used insulin, three took oral medication and the last two relied on diet alone.
The blood flow was measured by using a fetal Doppler echocardiography, which is part of an ultrasound examination that looks at the heart or blood vessels. A computerised model was used to collect the results and copy the circulation of the fetus.
Dr Kulkarni added: “The computational model equivalent of the fetal circulation is an electrical circuit where there are resistances and compliances. It is easier for blood to flow to the placenta, and harder for blood to flow to the brain.
“The placenta gets taken away after a baby is born so it’s no longer a part of the circulation. But it’s possible that the reduced circulation to the brain in utero could affect the baby through life.
“We don’t know enough about why this redistribution of blood flow occurs or the implications it might have. More research is needed to find out if this has any long-term impact on the health of the baby and whether anything can be done to prevent it.”
Despite showing that blood is diverted away from the brain to the placenta in pregnant women with diabetes, Dr Kulkarni said: “I don’t think any changes should be made in management of pregnant women with diabetes mellitus based on these findings.
“Standard obstetric recommendations for strict glucose control and healthy lifestyle should be continued.”
The research was unveiled at the European Association of Cardiovascular Imaging (EACVI), which is part of the European Society of Cardiology (ESC) and took place in Germany earlier this month.