بیماری‌های مادرزادی قلب در نوزادان مادران دیابتیک: یک بررسی اکوکاردیوگرافیک

Introduction: Despite the discovery of insulin and current improvement in diabetics care, congenital malformations in diabetics are still more frequent than in the general population. The aim of this study was to identify congenital heart dieases (CHD) in the newborns of diabetic mothers (IDMS). Methods: In our prospective study, color doppler echocardiography was performed in 75 consecutive full- term newborns of diabetic mothers by GE Vivid3 echocardiographic device. Newborns were classified into two subgroups according to the type of the mothers’ diabetes: pre-gestational and gestational. They were also those were classified into three subgroups according to their birth weight: appropriate, large and small for gestational age. Data analysis was made by Fisher exact test and Chi-Square test. Results: Forty nine (65%) and thirty six (35%) of subjects were infants of gestational (IGDM) and pre-gestational diabetic mothers (IPDM), respectively. Fifty five Newborns (73%) were apropriate, fourteen (19%) were large and six (8%) were small for gestational age. The most common echocardiographic findings included: patent ductus arteriosus (PDA: 54.7%), hypertrophic cardiomyopathy (HCMP: 24%), ventricular septal defect (VSD: 4%), atrial septal defect (ASD: 2.7%), transposition of great arteries (TGA: 1.3%) and coarctation of the Aorta (COA: 1.3%). Overall incidence of congenital heart diseases was 9.3 after exclusion of PDA and HCMP cases. The incidence of congenital heart diseases was higher in macrosomic than nonmacrosomic infants of diabetic mothers (P<0.001). Congenital heart diseases were more common in infants of pre-gestational than gestational diabetic mothers (P=0.004). Conclusion: Our results showed that diabetic mothers are at increased risk of giving birth to a newborn with congenital heart disease, and transthoracic echocardiography is recommended for all infants of diabetic mothers.