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Echocardiographic assessment of infants born to diabetic mothers
A K Deorari1, A Saxena, M Singh
1Department of Paediatrics, All India Institute of Medical Sciences, New Delhi.
Insights
Neonates born to diabetic mothers show thickened heart septums and increased left ventricular mass. Echocardiography reveals these changes, which can regress over time, impacting infant cardiac health.
Area of Science:
- Neonatal Cardiology
- Pediatric Echocardiography
- Maternal Diabetes Complications
Background:
- Maternal diabetes mellitus is associated with adverse neonatal outcomes.
- Cardiac abnormalities in infants of diabetic mothers require thorough investigation.
- Echocardiography is a key diagnostic tool for assessing neonatal cardiac structure and function.
Purpose of the Study:
- To evaluate cardiac morphology and function in neonates born to diabetic mothers using echocardiography.
- To compare echocardiographic findings between neonates exposed to maternal diabetes and a control group.
- To assess the interventricular septum thickness, left ventricular mass, and contractility in these infants.
Main Methods:
- Echocardiography was performed on 31 neonates from diabetic mothers (group 1) and 37 matched controls (group 2).
- Measurements included interventricular septum thickness, left ventricular internal dimension, right ventricular outflow tract, left atrial size, aortic size, left ventricular mass, and contractility.
- Pulse Doppler echocardiography was used to assess for left ventricular outflow obstruction.
Main Results:
- Significantly thicker interventricular septum in group 1 (4.77 mm) vs. group 2 (2.5 mm).
- Eight infants in group 1 had septum thickness >5 mm, with regression in six over three months.
- Significantly greater left ventricular mass and contractility in group 1 infants.
- No significant differences in left ventricular internal dimension, RV outflow tract, left atrium, or aorta size.
- No evidence of left ventricular outflow obstruction found in group 1.
Conclusions:
- Infants born to diabetic mothers exhibit significant interventricular septal thickening and increased left ventricular mass.
- These cardiac changes, assessed by echocardiography, can be dynamic and may regress.
- Echocardiography is crucial for identifying and monitoring cardiac adaptations in neonates of diabetic mothers.
Abstract:
Echocardiography was carried out in 31 neonates (group 1) born to diabetic mothers and 37 control infants (group 2) matched for weight and gestational age. The interventricular septum was significantly thicker in group 1 babies (mean (SD) 4.77 (1.4) mm) compared with those in group 2 (2.5 (0.7) mm); in eight it was more than 5 mm, but had regressed in six over a period of three months. There was no significant difference between the two groups in the left ventricular internal dimension, right ventricular outflow tract, or size of the left atrium or the aorta. The left ventricular mass was significantly greater in infants born to diabetic mothers. The left ventricular contractility (judged by the percentage of shortening of the internal dimension and the ejection fraction) was significantly greater in group 1. No evidence of left ventricular outflow obstruction was found on pulse Doppler echocardiography in group 1.