Echocardiographic Findings in Infants of Diabetic Mothers

Background Maternal diabetes mellitus (DM) is a well-established risk factor for congenital heart disease (CHD) in neonates. Despite advances in perinatal care, infants of diabetic mothers (IDMs) remain at increased risk for both structural lesions and functional cardiac changes. Objective To determine the prevalence and spectrum of echocardiographic abnormalities in neonates of diabetic mothers and compare them with matched controls. Methods A retrospective analytical study was conducted at King Fahad Hospital, Al Baha, from January 2024 to June 2025. Two hundred neonates (100 IDMs, 100 controls) underwent standardized echocardiographic assessment within the first week of life. Maternal and neonatal data were reviewed, and statistical analyses were performed to assess associations with clinical variables. Results Pathological CHDs were detected in 24% of IDMs, most commonly ventricular septal defect, patent ductus arteriosus, and hypertrophic cardiomyopathy. Transitional findings such as patent foramen ovale and small patent ductus arteriosus (PDA), considered physiological at this age, were present in 64%, while only 12% had completely normal echocardiograms. Lower birth weight-for-gestational-age was significantly associated with CHD (p = 0.026). No consistent differences were observed by maternal diabetes type or management modality. Conclusion IDMs are at significantly higher risk of structural congenital cardiac anomalies compared with controls, irrespective of maternal diabetes type. Early echocardiographic screening within the first week of life enables prompt detection and follow-up of clinically relevant lesions. Given the lack of long-term follow-up in this study, ongoing surveillance is recommended to determine the natural history and prognostic significance of these findings. Integration of IDM cardiac screening into regional neonatal care policies should be considered in high-prevalence settings such as Saudi Arabia.