Hypertrophic cardiomyopathy in infants of poorly-controlled diabetic mothers

Area of Science:

• Neonatal Cardiology
• Maternal-Fetal Medicine
• Pediatric Intensive Care

Background:

• Infants born to mothers with poorly controlled diabetes are at risk for various complications.
• Neonatal intensive care is crucial for managing these high-risk newborns.
• Cardiac abnormalities in neonates of diabetic mothers require specific diagnostic and therapeutic approaches.

Purpose of the Study:

• To describe the cardiac manifestations in newborns of poorly-controlled diabetic mothers.
• To investigate the echocardiographic findings and clinical course of these infants.
• To differentiate cardiac issues related to macrosomia from those in appropriately grown infants.

Main Methods:

• Retrospective analysis of twelve newborn infants requiring neonatal intensive care.
• Clinical assessment including respiratory distress and cardiomegaly.
• Echocardiographic evaluation to assess myocardial structure, function, and dynamic subaortic stenosis.

Main Results:

• Ten large-for-dates (macrosomic) infants exhibited myocardial hypertrophy and signs of subaortic stenosis.
• Functional subaortic stenosis resolved within 4-7 days in survivors, while hypertrophy persisted for at least 2 weeks.
• Two appropriately grown infants presented with cardiomegaly due to ventricular dilatation, associated with hypoglycemia and acidosis, which resolved upon correction.

Conclusions:

• Neonatal cardiac dysfunction, including myocardial hypertrophy and functional subaortic stenosis, is a significant complication in infants of poorly-controlled diabetic mothers.
• Echocardiographic findings in macrosomic infants resemble adult idiopathic hypertrophic subaortic stenosis.
• Ventricular dilatation and associated metabolic disturbances in appropriately grown infants require prompt correction.