Congenital Heart Disease in Pregnancies Complicated by Maternal Diabetes Mellitus (original) (raw)
Related papers
Congenital Heart Disease and Maternal Diabetes Mellitus
International Journal of Diabetes & Clinical Diagnosis, 2016
Introduction: Diabetes mellitus is a relatively common illness that can complicate pregnancy and result in an increased incidence of congenital malformations. Offspring of diabetic mothers suffering from type IDDM have a fivefold incidence of congenital malformations compared to pregnancies in the general healthy population. Specifically, the pattern of congenital heart disease (CHD) encountered among this group, with an emphasis on abnormalities of laterality, looping and conotruncal septation, suggesting that the maternal metabolic state affects cardiogenesis at a very early stage of the developmental period, prior to 7 weeks of gestation. Although many have been written on the effect of diabetes in pregnant women, less is known for the effects of type II DM and gestational diabetes mellitus (GDM) and its role in provoking CHD. Aim of this paper is to review the literature regarding the types of CHD seen in offspring of mothers suffering from different types of diabetes mellitus, maternal types 1 and 2 and gestational and to comment on the incidences and any differences found in the types of detected CHD. Method: a systematic literature resurge of the last 15 years was reviewed focusing to produce answers on the aims of the study. Conclusions: based on the existing evidence high frequency of CHD can be found in any type of maternal diabetes mellitus. For this reason, we believe that any type of diabetes present in a pregnancy must be a strong indication undergoing specific special fetal cardiac prenatal screening, aiming to detect possible CHD.
Einstein, 2008
einstein. 2008; 6(1): [42][43][44][45][46][47][48][49][50] Diabetes and pregnancy: analysis of pregnant women submitted to fetal echocardiography during a ten-year period Diabetes e gestação: análise das gestantes submetidas à ecocardiografia fetal em um período de dez anos aBStract Objectives: To analyze diabetic pregnant women who underwent fetal echocardiography , from April 1993 to December 2003, and to identify the fetal echocardiographic abnormalities and postnatal outcome. Methods: A retrospective cross-sectional study of 178 diabetic pregnant women who underwent fetal echocardiography. Clinical and laboratory maternal, fetal echocardiographic, delivery and newborn variables were studied. Means were calculated for quantitative variables and percentages for qualitative variables. Analysis of variance, Student's t test and the Dunnet's test were used. The adopted level of significance was p < 0.05. results: There were 20,493 deliveries in the period considered, of which 380 were of diabetic mothers and 178 of them were studied. Mean age was 33.7 years (± 5.0). The mean body mass index (BMI) at the first prenatal appointment was 28.0 kg/m 2 . The majority (84.8%) underwent fetal echocardiography at ≥ 28 weeks of gestation. Nine cases of interventricular septum hypertrophy were found (5.1%), three cases (1.7%) of cardiac malformation were identified, one of which was a false-positive and, among the normal cases, one false-negative was identified. Six stillbirths occurred, three from women with gestational diabetes (2.4%) and three from type 2 diabetics (6.3%, p = 0.305). The rates of major congenital malformations among gestational and type 2 diabetes were 5.6 and 10.4%, respectively (p = 0,322). conclusions:
Türk Pediatri Arşivi, 2015
In this study, we aimed to evaluate the postnatal problems of infants of mothers with pregestational and gestational diabetes and the clinical properties of infants who were found to have congenital cardiac disease. Material and Methods: We retrospectively examined the records of 337 newborns who were followed up with a diagnosis of infant of diabetic mother between January 2010 and January 2012 in our Neonatology Unit. The demographic data of the diabetic mothers and their babies, the postnatal problems of the babies of diabetic mothers and congenital heart diseases found on transthoracic echocardiography were examined. Results: The patients were classified as group A, B and C in accordance with the recommendations of The American Congress of Obstetricians and Gynecologists (ACOG) according to the type of diabetes. The most common postnatal problems included hyperbilirubinemia, respiratory distress, hypoglycemia and hypocalcemia. The rate of congenital heart disease was found be 17.3% in group A, 50% in group B and 9% in group C. No correlation was found between congenital heart disease and gender, multiple pregnancy, diabetes type, diet treatment, use of oral antidiabetic drugs and drug usage. A positive significant correlation was found between congenital heart disease and genetic disease, murmur, cyanosis and presence of gestational hypertension. It was shown that use of insulin, genetic disease and presence of gestational diabetes increased the risk of congenital heart disease. Conclusions: In our study, the overall incidence of congenital heart disease was found to be 24% in infants of diabetic mothers. It should be kept in mind that it is important to investigate the infants of mothers with pregestational and gestational diabetes in terms of the risk of congenital heart disease.
The Incidence of Congenital Heart Defects in Offspring Among Women With Diabetes in Saudi Arabia
Cureus, 2021
Background: The risk of congenital anomalies is increased in infants of diabetic mothers (IDM). The most frequent cardiac anomalies in IDMs include ventricular septal defect, transposition of great arteries, and aortic stenosis. Objective: Estimating the incidence of infants with congenital heart defects (CHD) whose mothers have diabetes in Saudi Arabia at a tertiary hospital in the National Guard Health Affairs (NGHA) system. Materials and methods: This study was a retrospective cohort. The population was all births of type 1 and type 2 diabetic mothers and non-diabetic mothers (also mothers with gestational diabetes) in NGHA by following the exclusion criteria, which were mothers over 40 and below 20 years of age, and other risk factors such as drug-induced congenital disease. The data was from deliveries from January 1st 2018 to January 1st 2019. Data were collected by chart review using the Best-Care system at NGHA hospital. Statistical Package for the Social Sciences (SPSS) version 20 (IBM Corp., Armonk, NY, USA) was used for the statistical analysis. Results: A total of 1838 diabetic mothers and non-exposure, non-diabetic mothers, with the outcome of whether the infant had CHD, were included in this study. Most of the mothers (544, 30.11%) were aged 30-34 years old. About two-thirds of mothers, 1161 (63.24%), weren't diabetic, 500 (27.23%) had gestational diabetes, 132 (7.19%) were type 2 diabetes (T2DM), and 43 (2.34%) were type 1 diabetes (T1DM). Two hundred eighteen (11.82%) offspring had CHD, and the remaining 1625 (88.17%) did not. The most frequent echocardiographic abnormalities in infants of diabetic mothers were patent ductus arteriosus (PDA) (31.75%), patent foramen ovale (PFO) (31.75%), and atrial septal defect (ASD) (23.64%). Conclusion: The incidence of CHD among infants of included mothers in this cohort study was 11.82%. The most frequent echocardiographic abnormalities in the infants of diabetics were PDA and PFO. The incidence of CHD was higher among mothers who had T1DM followed by T2DM, and whose ages were between 30-34.
Impact of Gestational and Pre-Gestational Diabetes Mellitus on the Foetal Heart
2020
Foetal cardiac structural and functional features have been examined in pregnancies diabetic and non-diabetic and healthy pregnancies. During 15.1.17-15.7.17, cardiac structure and function assessment was scheduled of 50 healthy pregnant women, 25 pregnant women with gestational diabetes and 25 with pre-gestational diabetes. The thickness of foetal interventricular septum (IVS) was significantly more in diabetic group as compared to non- diabetics (p < 0.05) but no one was having an IVS > 2 SD from normal. The top velocity of tricuspid E and the ratio of E/A was considerably low in diabetic group (p < 0.05). Values of tricuspid valve Ea and the ratio of Ea/Aa were less in the diabetic group as compared to control group (p<0.05)but there was no considerable difference in between pre-gestational diabetes mellitus and gestational diabetes mellitus (p > 0.05). In diabetic pregnancies the most common structural abnormality is the interventricular septal hypertrophy. No ris...
Journal of Evolution of Medical and Dental Sciences
BACKGROUND Maternal diabetes mellitus is a relatively common disease that complicates pregnancy and results in an increased incidence of congenital malformations, predominantly congenital heart disease. Glycated haemoglobin (HbA1c) is accepted as an indicator of glycaemic control and correlates with increased risk of congenital anomalies. There is lack of enough studies in India addressing the relationship between the level of glycaemic control in diabetic pregnancy and the incidence of congenital cardiac anomalies. The objective of this study was to determine the cardiovascular morbidity of infants of diabetic mother and to study the association between the maternal glycaemic control according to HbA1c and the cardiac status of the baby. Another objective was to estimate the frequency of various congenital heart defects in such infants. We also looked at possible relationship between variables like birth weight of the neonates and the need for insulin to control maternal diabetes and incidence of congenital heart disease. Design-Descriptive study. Setting-Tertiary care government medical college hospital in Kerala catering to urban and rural population belonging predominantly to the lower socioeconomic strata. MATERIALS AND METHODS All the antenatal women with positive Glucose Tolerance Test (GTT) admitted over a period of 8 months were included in the study. They were interviewed using a semistructured questionnaire and HbA1c testing was done within the third postnatal day. The cardiological status of the babies was assessed clinically and by ECHO within the first week after birth. RESULTS Out of total 71 diabetic women, 68(96%) had gestational diabetes and 3(4%) had overt diabetes; 14 babies (20%) were large for gestational age and 4(5%) were small for gestational age; 47.8% of Infants of Diabetic Mothers (IDMs) had congenital heart disease and 9.9% had Asymmetric Septal Hypertrophy (ASH). Among the Congenital Heart Diseases (CHD), maximum were Atrial Septal Defects (ASD) followed by Ventricular Septal Defects (VSD) and Patent Ductus Arteriosus (PDA). The mean birth weight in the group with CHD was significantly higher at 3.22 Kg as against 2.89 Kg. The presence of ASH had statistically significant association with higher HbA1c. CONCLUSION This study emphasises the higher frequency of CHD among infants of diabetic mother, ASD being the most common heart disease detected. There was statistically significant association between elevated postnatal HbA1c and diabetic cardiomyopathy.