What is the clinical evidence from this study?

Study design: Cohort. Population: Diabetic pregnancy (n=87). Intervention: Type 1 and Type 2 diabetes vs. Gestational diabetes. Primary outcome: Pathologic ventricular hypertrophy (PVH).

December 12, 2006Open Access

Pathologic ventricular hypertrophy in the offspring of diabetic mothers: a retrospective study

Key Result

Pregnancies with type 1 and type 2 diabetes carried a higher risk of fetal pathologic ventricular hypertrophy (50% and 25%, respectively) compared to gestational diabetes (1 of 54).

Study Design

Type

Cohort (n=87)

Structured PICO

Does type 1 and type 2 diabetes in pregnancy increase the risk of pathologic ventricular hypertrophy in offspring compared to gestational diabetes?

Population

87 diabetic pregnancies (16 type 1, 17 type 2, 54 gestational diabetes) resulting in 92 neonates, evaluated retrospectively for pathologic ventricular hypertrophy.

Exposure

Type 1 or Type 2 diabetes mellitus during pregnancy

Comparator

Gestational diabetes

Outcome

Pathologic ventricular hypertrophy (PVH)surrogate

Pregnancies with type 1 and type 2 diabetes carry a significantly higher risk of fetal pathologic ventricular hypertrophy compared to gestational diabetes.

Main Result

Absolute Event Rate: 50% vs 1.85%

Abstract

AIMS: Diabetes in pregnant women is increasing and with that the complications in their offspring. We studied our population of diabetic mothers (2003-2005) for pathologic ventricular hypertrophy (PVH). METHODS AND RESULTS: In our retrospective study of all 87 diabetic pregnancies (92 neonates), 16 were type 1, 17 were type 2, and 54 were gestational diabetes (GD). Haemoglobin glycated (HbA1c) median was 5.8% (5.3-6.5): 17 with HbA1c above normal 2 with congenital heart disease (CHD) and six with PVH. A total of 75 neonates were normal, five had CHD, and 12 had PVH (1/12 died post-natally, 1/12 stillborn, 2/12 required premature delivery, 8/12 normal). The 16 type 1 pregnancies resulted in three neonates with CHD and in 50% PVH, including one death, one premature Cesarean section because of PVH. The 17 neonates of type 2 pregnancies showed in one CHD and in 25% PVH. Of the 54 GD pregnancies, one had CHD and one had PVH. CONCLUSION: Pregnancies of both type 1 and 2 diabetes carry an increased risk for foetal development of PVH compared with those with GD. The insufficient effect of preventive glycaemia controls leads to conclude that although no definite predictive parameters for malignant outcome can be presented, close monitoring of these pregnancies may prevent perinatal catastrophes.