Key result
Maternal diabetes is linked to a 28% prevalence of infant cardiac abnormalities, highest with insulin.
Why the study?
Maternal diabetes is a common problem with increasing gestational diabetes prevalence, and its association with cardiovascular abnormalities in infants is important to characterize.
Observational (n=100)
No
Maternal diabetes, particularly when requiring insulin therapy, is associated with a high risk of congenital heart disease in newborns, emphasizing the need for early echocardiographic screening.
May support echocardiographic screening in infants of insulin-treated diabetic mothers; leaves open causal role of insulin versus hyperglycemia.
Background Diabetes mellitus is one of the most common medical problems among pregnant women. Now, gestational diabetes mellitus (GDM) is increasing and amounts to 17% in Asian women but only in 4% of American and European women. In southern India, the prevalence of GDM is 17% in urban women, 13.8% in semiurban, and 9.8% in rural women. Aim The aim of the study is to find the cardiovascular abnormalities in infants born to a diabetic mother (IDM) and the association between infant’s heart lesion and diabetes mellitus in pregnant mother in a tertiary care center. Materials and Methods All babies born to both pregestational and gestational diabetic mother were included. Information regarding maternal type of diabetes, treatment regimen, maternal glycemic control status, antenatal ultrasonogram, baby’s sex, birth weight, gestational age, and clinical features were collected. Echocardiogram was done for all the babies. Results Out of the 100 IDM, 28 babies had cardiac disease, 5 babies had cyanotic heart disease, and 23 babies had acyanotic heart disease. Out of 100 diabetic mothers, 66 were on meal plan, 21 were on oral hypoglycemic agent (OHA) metformin, and 13 were on insulin therapy. Among 66 babies whose mother was on the meal plan, 8 had cardiac abnormality. Among the 21 mothers on OHA, 7 babies had cardiac abnormality and all the 13 babies of mothers who were on insulin had cardiac abnormality which was a significant finding among the IDM. Conclusion Maternal diabetes is a significant risk factor for heart disease in the newborn. Careful evaluation and early diagnosis of heart diseases in this high-risk group is of great value. Both pregestational and gestational diabetic mothers should monitor their blood sugar and maintain it in a normal range at the time of conception and early in pregnancy to reduce the risk of congenital heart disease in IDM.
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Arul et al. (2019) conducted an observational in Infants born to diabetic mothers (n=100). Maternal diabetes was evaluated on Cardiac abnormality. Maternal diabetes was associated with a 28% prevalence of cardiac abnormalities in infants, with the highest rate (100%) seen in infants of mothers on insulin therapy.
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