Echocardiographic findings in infants of diabetic mothers and their relation to maternal glycemic control

Background Diabetes mellitus during pregnancy is a common risk factor for both mothers and infants. Prediction of cardiac problems in infants of diabetic mothers is challenging. Aim The purpose of the study is to determine the type and incidence of congenital heart diseases in infants whose mothers are diabetic in the NICU of Alexandria university maternity hospital, as well as to evaluate functional and morphological changes in the myocardium and its relationship to maternal glycemic control. Patients and methods A case-control study was conducted in the NICU of Alexandria University Hospital. Thirty-five infants of diabetic mothers (IDM) were compared to 37 healthy control infants. All diabetic mothers had their HBA1C levels measured before delivery. Therefore, the infants of diabetic mothers were further divided into 22 infants whose mothers had controlled diabetes (controlled DMM group; controlled diabetes mellitus mothers group) during pregnancy (predelivery HBA1C ≤ 6.5) and 13 infants whose mothers had uncontrolled diabetes during pregnancy (uncontrolled DMM group). All studied infants were scanned for the presence of congenital heart diseases. Right and left ventricular systolic functions were assessed, and septal and left ventricular dimensions were measured using functional echocardiography (FE). Followup scans were done 1–2 months later. This work was registered on clinical trial.gov NCT05050058 Results Incidence of congenital heart diseases is significantly increased in infants of diabetic mothers compared to healthy control group with P value =0.008. Intraventricular septal thickness and left ventricular posterior wall during systole and diastole (IVSs, IVSd, LVPWs, LVPWd and IVSd/ LVPWd ratio) significantly increased in IDM group. Patients whose mothers had uncontrolled diabetes had their IVSd and IVSd/ LVPWd ratio markedly increased over the uncontrolled group. After 45–60 days the septal and posterior wall measures during systole and diastole decreased significantly. Tricuspid regurge (TR) gradient is markedly increased in IDM in the first 24 h after birth, specifically in infants with mothers with poor glycemic control during pregnancy. Conclusion Infants of diabetic mothers were significantly more likely to suffer from ASD, VSD, and complex heart disease. Complex heart diseases were significantly associated with pregestational maternal diabetes. Infants of diabetic mothers with poor glycemic control have affected IVSd and IVSd/LVPWd ratios. Ventricular septal and LVPW measures were markedly improved after 45–60 days of age .Neither the presence of maternal diabetes nor the diabetic control of mothers affected the right and left ventricular functions of their infants.