Maternal diabetes in pregnancy is related with primary oddities of the fetal heart, just as hypertrophy and practical disability. This deliberate audit and meta‐analysis intended to gauge the impact of maternal diabetes on fetal cardiovascular capacity as estimated by pre-birth echocardiography. Strategies We played out an inquiry of the EMBASE, PubMed and The Cochrane Library data sets, from commencement to 4 July 2019, for contemplates assessing fetal heart work utilizing echocardiography in pregnancies influenced by diabetes contrasted and straightforward pregnancies. Result measures were cardiovascular hypertrophy and diastolic, systolic and by and large heart work as evaluated by different ultrasound boundaries. The nature of the investigations was surveyed utilizing the Newcastle–Ottawa Scale. Information on interventricular septal (IVS) thickness, myocardial execution list (MPI) and E/A proportion were pooled for the meta‐analysis utilizing random‐effects models. For pregnancies with diabetes, results were accounted for in general and as per whether diabetes was pregestational (PDM) or gestational (GDM). Results were additionally separated by the trimester in which fetal cardiovascular evaluation was performed. Results Thirty‐nine investigations were incorporated, containing information for 2276 controls and 1925 ladies with pregnancy influenced by diabetes mellitus (DM). Of these, 1120 had GDM, 671 had PDM and in 134 cases diabetes type was not determined. Fetal cardiovascular hypertrophy was more predominant in diabetic pregnancies than in non‐diabetic controls in 21/26 examinations, and debilitated diastolic capacity was seen in diabetic pregnancies in 22/28 investigations. The relationship among DM and systolic capacity was conflicting, with 10/25 investigations revealing no distinction among cases and controls, albeit later examinations estimating cardiovascular distortion, for example strain, showed diminished systolic capacity in diabetic pregnancies. Of the examinations estimating in general fetal heart work, the lion's share (14/21) discovered huge debilitation in diabetic pregnancies. Results were comparative when separated by GDM or PDM. These impacts were at that point present in the primary trimester, yet were generally significant in the third trimester. Meta‐analysis of studies acted in the third trimester appeared, contrasted and controls, expanded IVS thickness in both PDM (mean distinction, 0.75 mm (95% CI, 0.56–0.94 mm)) and GDM (mean contrast, 0.65 mm (95% CI, 0.39–0.91 mm)) pregnancies, diminished E/A proportion in PDM pregnancies (mean distinction, – 0.09 (95% CI, – 0.15 to – 0.03)), no distinction in E/A proportion in GDM pregnancies (mean contrast, – 0.01 (95% CI, – 0.02 to 0.01)) and no distinction in MPI in either PDM (mean contrast, 0.04 (95% CI, – 0.01 to 0.09)) or GDM (mean contrast, 0.03 (95% CI, – 0.01 to 0.06)) pregnancies. Ends The discoveries of this audit show that maternal diabetes is related with fetal cardiovascular hypertrophy, diastolic brokenness and generally weakened myocardial execution on pre-birth ultrasound, independent of whether diabetes is pregestational or gestational. Further investigations are expected to show the relationship with long‐term results. © 2020 The Authors. Ultrasound in Obstetrics and Gynecology distributed by John Wiley and Sons Ltd for International Society of Ultrasound in Obstetrics and Gynecology. Q