Jsmc-10264

INCIDENCE OF CONGENITAL HEART DISEASE AMONG INFANTS OF DIABETIC MOTHERS IN SULAIMANI

Mohammed Jazaa Ahmed a, Adnan M Hassan b, and Alan Abdulla Abdulrahman b

a Candidate of KBMS Pediatrics; Sulaimani Health directorate, Sulaimani, Kurdistan Region, Iraq.

b Department of Paediatrics, College of Medicine, University of Sulaimani, Kurdistan Region, Iraq. 

 

Submitted: 11/7/2019; Accepted: 27/7/2020; Published: 21/9/2020

DOI Link: https://doi.org/10.17656/jsmc.10264 

ABSTRACT

Background 

Infant of diabetic mother (IDM) is those infants born to mothers who suffered diabetes mellitus. There are two types of IDM, Gestational diabetes and Pregestaional diabetes. Both have the effects on morphogenesis of infants’ cardiovascular system and increase the risk of congenital heart disease.

Objectives 

To find out the incidence of congenital heart disease among infants of pregestational diabetic mothers.

Patients and Methods

In a prospective study that included 32 infants of pregestational diabetic mother (PGDM) age less than 7 days at the neonatal intensive care unit NICU of Sulaimani-Shar hospital and NICU of Sulaimani-Maternity hospital during the period April 1st, 2018 to March 31st, 2019.Echocardiography and abdominal ultrasound were done for all babies. 

Results

There were 32 infants of PGDM during the study period. Mean mothers’ age was 35.43±6.49, Last hemoglobin A1C (mean±SD) 7.23±1.17. Males and females were 17(53.1%) and 15(46.9%) respectively. Gestational age; 21 (65.6%) were term and 11 (34.4%) were preterm. Birth weight (mean±SD) 3.45±0.69. Twenty-eight (87.5%) were delivered by caesarian section C/S and 4 (12.5%) by normal vaginal delivery NVD. Echocardiography finding revealed 24 (75%) infants had CH, most common CHD were hypertrophic cardiomyopathy HCMP (40.5%), PDA (28%), ASD (18.9%). Most cases of CHD are term, male, delivered by caesarian section, mothers’ body mass index between 25 to 29.9, type 2 diabetic and less than 5 years diagnosed. Abdominal ultrasound showed 26(84.4%) were normal 5 (15.6%) were abnormal. 

Conclusion

According to our study, most of the newborn of PGDM had congenital heart disease. Most common CHDs were hypertrophic cardiomyopathy, PDA and septal defects.

K

KEYWORDS

Infants of diabetic mother; Congenital heart disease; Sulaimani.

References 

1. Al Najashi S.S.: Control of Gestational Diabetes. Int. Jour.Gynecol.Obstet.1995; 49:131-5

2. Corderol, Landon M. B.: Infant of diabetic mother. Clinical perinatal 1993; 20: 635 – 48

3. Comblath M., Hawdon j. M. Williams A. F.: Controversies Regarding Definition of Neonatal Hypoglycemia: Suggested Operational Threshold Pediatrics 2000 May; 105 (5): 1141-5.

4. Farrar D, Tuffnell DJ, West J. Continuous subcutaneous insulin infusion versus multiple daily injections of insulin for pregnant women with diabetes. Cochrane Database Syst Rev. 2007. p. CD005542.

5.  Blackburn, S. (2003). Maternal, fetal, and neonatal physiology: A clinical perspective (2nd ed.). St. Louis: WB Saunders.

6.  Armentrout, D. Glucose management. In M. T. Verklan & M. Walden (Eds.), Core curriculum for neonatal intensive care nursing. St. Louis: Elsevier Saunders.2004, 3rd ed., pp. 192–204.

7.  Otolorun EO, Famuyiwa oo, Bello AF, Da-Wodu AH, Adelusi B: Reproductive performance following active management of diabetic pregnancies at University College Hospital, Ibadan, Nigeria. Afr J Med Sci 1985, 14(3-4):155-60.

8. Engelgau MM, Herman NH, Smith PJ, German RR, Aubert RE: The epidemiology of diabetes and pregnancy in the US. 1988. Diabetic care 1995, 18(7):1029-1033.

9.  Abbott ME. Atlas of Congenital Cardiac Disease. New York, NY: The American Heart   Association; 1936.

10.  Nina Øyen, Lars J. Diaz, Elisabeth Leirgul, Heather A. Boyd, James Priest, Elisabeth R. Mathiesen, et al: Prepregnancy Diabetes and Offspring Risk of Congenital Heart Disease: Circulation. 2016 Jun 7; 133(23): 2243–2253.

11.Suevo D.M: Infant Of Diabetic Mother. Neonatal Netw.1997;16:25-33.

12. Nina Øyen, Lars J. Diaz, Elisabeth Leirgul, Heather A. Boyd, James Priest, Elisabeth R. Mathiesen, et al: Prepregnancy Diabetes and Offspring Risk of Congenital Heart Disease: Circulation. 2016 Jun 7; 133(23): 2243–2253.

13. Mohamed Akhatim Alsammani and Salah Roshdy Ahmed: Grand Multiparity: Risk Factors and Outcome in a Tertiary Hospital: a Comparative Study. Mater Sociomed. 2015 Aug; 27(4): 244–247.

14. Sibai BM1, Caritis SN, Hauth JC, MacPherson C, VanDorsten JP, Klebanoff M et al: Preterm delivery in women with pregestational diabetes mellitus or chronic hypertension relative to women with uncomplicated pregnancies. The National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network. Am J Obstet Gynecol. 2000 Dec; 183(6):1520-4 

15. Behjati M, Modarresi V, Rahimpour S, Behjati M. Congenital Heart Diseases in the Newborns of Diabetic Mothers: An Echocardiographic Study. Journal of Shahid Sadoughi University of Medical Sciences. JSSU. 2011; 19 (4):511-517.

16. Thanh T. Hoang, Lisa K. Marengo, Laura E. Mitchell, Mark A. Canfield, and A. J. Agopian: Original Findings and Updated Meta-Analysis for the Association Between Maternal Diabetes and Risk for Congenital Heart Disease Phenotypes: Department of Epidemiology, Human Genetics, and Environmental Science, School of Public Health, UT Health Science Center at Houston, 1200 Pressler Street, Houston. American Journal of Epidemiology, 2017 Jul 1; 186(1): 118–128.

17. Roman Starikov, Justin Bohrer, William Goh, Melissa Kuwahara,chein EK, Vrishali Lopes, et al: Hemoglobin A1c in Pregestational Diabetic Gravidas and the Risk of Congenital Heart Disease in the Fetus. Washington Hospital CenterWashington USA. Pediatr Cardiol, October 2013, Volume 34, Issue 7, pp 1716–1722. 

18. Correa A, Gilboa SM, Besser LM, Botto LD, Moore CA, Hobbs CA, et al: Diabetes mellitus and birth defects.Am J Obstet Gynecol. 2008 Sep; 199(3):237.e1-9.

19. Phillipa B. Sharpe, Annabelle Chan  Eric A. Haan  Janet E. Hiller: Maternal diabetes and congenital anomalies in South Australia 1986–2000: A population‐based cohort study. Melbourne, Victoria, Australia. Wiley online library, Birth Defects Research Part A: Clinical and Molecular Teratology: 08 July 2005, Volume 73, Issue 9:605-611.

20. Cousin s L.Pregnancy Complication Among Diabetic Women: Obstetric Gynecol 1997;42:140.

Full Text

 © The Authors, published by University of Sulaimani, College of Medicine

This work is licensed under a Creative Commons Attribution 4.0 International License.