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Echocardiographic abnormalities in infants of diabetic mothers
Insights
Infants of diabetic mothers (IDM) frequently show cardiac hypertrophy and potential heart issues. Poor maternal diabetes control strongly correlates with these infant cardiac abnormalities.
Area of Science:
- Cardiology
- Neonatology
- Pediatric Cardiology
Background:
- Infants of diabetic mothers (IDM) are at increased risk for cardiovascular complications.
- Postnatal cardiovascular adaptation in IDM requires careful evaluation.
Purpose of the Study:
- To assess myocardial hypertrophy and postnatal cardiovascular adaptation in infants of diabetic mothers.
- To correlate clinical findings with echocardiographic parameters in IDM.
Main Methods:
- Echocardiograms were performed on 34 infants of diabetic mothers.
- IDM were categorized into groups based on cardiopulmonary assessment (congestive heart failure, respiratory distress, asymptomatic).
Main Results:
- Frequent interventricular septum and ventricular wall hypertrophy observed in IDM, particularly with congestive heart failure (CHF).
- Six IDM exhibited subaortic stenosis; four had CHF.
- Normal left ventricular performance indices were noted in all IDM, even with CHF.
- Elevated right ventricular pre-ejection period to ventricular ejection time ratio in IDM with respiratory distress indicated pulmonary circulation abnormalities.
- Poor maternal diabetes control and hypertension correlated with infant myocardial hypertrophy.
Conclusions:
- Infants of diabetic mothers frequently present with cardiac hypertrophy and potential functional abnormalities.
- Echocardiography is crucial for identifying cardiac changes in IDM.
- Maternal health factors significantly impact infant cardiovascular outcomes.
Abstract:
In order to evaluate the presence of myocardial hypertrophy and/or abnormalities of postnatal cardiovascular adaptation, echocardiograms were performed on 34 infants of diabetic mothers. Based on cardiopulmonary assessment, the IDM were divided into three groups: Group I with congestive heart failure predominating: Group II with respiratory distress predominating: Group III asymptomatic. Hypertrophy of the interventricular septum and of the walls of left and right ventricles was frequently present in IDM: this change was most notable in association with clinical CHF. Six IDM, four of whom were found to have CHF, had additional echocardiographic signs of subaortic stenosis. All IDM had normal indices of left ventricular performance, despite the presence of CHE. In IDM with respiratory distress, the right ventricular pre-ejection period to ventricular ejection time ratio was elevated, suggesting an abnormality of the transitional pulmonary circulation. Poor maternal diabetes control and maternal systemic hypertension were closely correlated with evidence of myocardial hypertrophy in the infants.