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Congenital heart disease in infants of diabetic mothers: echocardiographic study
1Division of Pediatric Cardiology, Department of Pediatrics, King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia. abusulaiman@mailzone.com
Insights
Infants born to mothers with insulin-dependent diabetes mellitus (IDDM) have a high incidence of congenital heart disease (CHD). Early diagnosis and prenatal screening are crucial for these high-risk infants.
Area of Science:
- Cardiology
- Neonatology
- Pediatrics
Background:
- Maternal insulin-dependent diabetes mellitus (IDDM) is a known risk factor for congenital heart disease (CHD) in neonates.
- Infants of diabetic mothers (IDMs) require careful cardiovascular assessment due to potential cardiac anomalies.
Purpose of the Study:
- To investigate the spectrum of congenital heart disease (CHD) in neonates born to mothers with insulin-dependent diabetes mellitus (IDDM).
- To determine the incidence and types of cardiac abnormalities in infants of diabetic mothers (IDMs).
Main Methods:
- A prospective study of 100 consecutive infants of diabetic mothers (IDMs) was conducted.
- Evaluations included maternal and family history, physical examination focusing on the cardiovascular system, and echocardiography.
Main Results:
- The most common findings were patent ductus arteriosus (PDA; 70%) and patent foramen ovale (PFO; 68%).
- Hypertrophic cardiomyopathy (HCMP) was present in 38% of cases. Overall CHD incidence, excluding PDA and HCMP, was 15%.
- Severe CHD like D-transposition of great arteries, tetralogy of Fallot, and hypoplastic left heart syndrome occurred in 1% each.
Conclusions:
- Maternal IDDM is a significant risk factor for congenital heart disease (CHD).
- Early and thorough cardiovascular evaluation of infants of diabetic mothers (IDMs) is essential.
- Prenatal screening programs for CHD in this high-risk population are recommended.
Abstract:
Our objective was to study neonates born to insulin-dependent diabetes mellitus (IDDM) mothers to detect the spectrum of congenital heart disease (CHD). Between July 2000 and June 2001, a prospective study of 100 consecutive infants of diabetic mothers (IDMs) at King Khalid University Hospital in Riyadh was undertaken. Family and maternal history, physical examination with special attention to the cardiovascular system, and echocardiography were performed. A total of 100 consecutive IDMs examined. The most common echocardiographic findings were patent ductus arteriosus (PDA; 70%), patent foramen ovale (68%), atrial septal defect (5%), small muscular ventricular septal defect (4%), mitral valve prolapse (2%), and pulmonary stenosis (1%). Hypertrophic cardiomyopathy (HCMP) was observed in 38% of cases, mainly hypertrophy of the interventricular septum. Severe forms of CHD encountered were D-transposition of great arteries, tetralogy of Fallot, and hypoplastic left heart syndrome (1% each). Isolated aortic stenosis and coarctation of aorta were not encountered in this series. Overall incidence of congenital heart disease was 15% after excluding PDA and HCMP. Maternal IDDM is a significant risk factor for CHD. Careful evaluation and early diagnosis of CHD in this high-risk group are highly indicated. There is a need for development of prenatal screening programs for CHD in our population.
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