Mortality among infants of diabetic mothers with hypertrophic cardiomyopathy

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Elijah H Bolin1, Beverly J Spray2, Peter M Mourani3

  • 1Department of Pediatrics, Section of Cardiology, University of Arkansas for Medical Sciences and Arkansas Children's Research Institute, Little Rock, AR, USA.

The Journal of Maternal-Fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians
|April 20, 2022
PubMed

Insights

Infants of diabetic mothers (IDMs) with hypertrophic cardiomyopathy (HCM) face a higher risk of in-hospital mortality. This study highlights the need for improved diagnostic criteria and interventions for HCM in this vulnerable population.

Area of Science:

  • Cardiology
  • Neonatology
  • Pediatrics

Background:

  • Maternal diabetes is a significant risk factor for adverse infant outcomes.
  • Infants of diabetic mothers (IDMs) are at increased risk for various congenital anomalies and cardiovascular complications.
  • Hypertrophic cardiomyopathy (HCM) is a potential complication in IDMs, but its association with mortality requires further investigation.

Purpose of the Study:

  • To evaluate the association between hypertrophic cardiomyopathy (HCM) and in-hospital mortality in infants of diabetic mothers (IDMs).

Main Methods:

  • A retrospective cohort study was conducted using the Pediatric Health Information System (2004-2019).
  • Hospitalized IDMs admitted at ≤14 days old were included.
  • Multivariable logistic regression analyzed the association between HCM and mortality, controlling for prematurity, sex, and congenital malformations.

Main Results:

  • Of 32,993 IDMs, 203 (0.6%) had HCM. Black and Hispanic infants were disproportionately represented among those with HCM.
  • IDMs with HCM had a significantly higher birth weight compared to those without HCM.
  • In-hospital mortality was higher in IDMs with HCM (4.9%) versus those without (1.3%), with adjusted odds ratio of 2.10 (95% CI: 1.04-4.25).

Conclusions:

  • Hypertrophic cardiomyopathy (HCM) is identified as a significant contributor to in-hospital mortality in infants of diabetic mothers (IDMs).
  • These findings underscore the necessity for refined diagnostic criteria and targeted therapies for HCM in IDMs.
  • Prevention of maternal diabetes and early detection of HCM in IDMs are crucial for improving infant outcomes.
Abstract

Keywords:
Infant of a diabetic motherdiabeteshypertrophic cardiomyopathy

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