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Gestational diabetes mellitus (GDM) is the most common metabolic disease that occurs during pregnancy and may result in fetal cardiac dysfunction. Our study aimed to assess the cardiac function in fetuses of mothers with GDM by a quantitative analysis software based on speckle-tracking echocardiography.Forty-nine fetuses exposed to GDM and 50 normal fetuses were enrolled, and fetal echocardiography were performed and analyzed in this prospective cross-sectional study. We compared cardiac systolic function between the two groups using fetal cardiac quantitative analysis software.In the GDM group, left ventricular (24 ± 4 versus 28 ± 4, P .001) and right ventricular global longitudinal strain (23 ± 4 versus 26 ± 4, P = .002) and right ventricular free wall strain (26 ± 6 versus 29 ± 5, P = .006) were significantly lower compared with the control group, whereas there was no significant difference in global spherical index (1.2 ± 0.1 versus 1.2 ± 0.1, P = .425). Additionally, 24-segment transverse fraction shortening of the right ventricle was more impaired than the left, and the segments with reduced fraction shortening were mainly located in the mid and apical sections of the right ventricle, and midsection of the left ventricle.Fetuses exposed to GDM may have cardiac dysfunction before the onset of cardiac morphologic abnormalities, and the right ventricle is more vulnerable than the left during fetal development.

Background Conflicting results have been obtained in trials that have evaluated the prophylactic efficacy of N ‐acetylcysteine ( NAC ) pretreatment in the prevention of contrast‐induced nephropathy ( CIN ). In this meta‐analysis of randomized controlled trials, we aimed to assess the effectiveness of NAC treatment for the prevention of CIN . Methods and Results PubMed, EMBASE , and the Cochrane Library were electronically searched from inception to January 2016 for all relevant studies. The weighted relative risk ( RR ) and corresponding 95% CI for incident CIN were estimated using random effects models. Standard methods for assessing statistical heterogeneity and publication bias were used. The study included 11 480 participants and 1653 cases of CIN . The incidence of CIN was 12.8% in the NAC group versus 16.0% in the control group ( RR : 0.76, 95% CI : 0.66–0.88, P =0.0002). In the patients undergoing coronary angiography, the incidence of CIN in the NAC group versus the control group was 13.7% versus 17.2% ( RR : 0.74, 95% CI : 0.63–0.87, P =0.0002); in those undergoing peripheral angiography, the incidence was 6.4% versus 5.8% ( RR : 1.00, 95% CI : 0.42–2.40, P =1.00); in those undergoing computed tomography, the incidence was 7.7% versus 14.8% ( RR : 0.51, 95% CI : 0.29–0.89, P =0.02). Conclusions Our meta‐analysis showed an inverse and significant association between NAC supplementation and risk of CIN in patients undergoing coronary angiography and computed tomography, while a protective role for NAC in patients undergoing peripheral angiography was not obvious.