Abstract
Our objective was to study neonates born to insulin-dependent diabetes mellitus (IDDM) mothers to detect the spectrum of congenital heart disease (CHD). Between July 2000 and June 2001, a prospective study of 100 consecutive infants of diabetic mothers (IDMs) at King Khalid University Hospital in Riyadh was undertaken. Family and maternal history, physical examination with special attention to the cardiovascular system, and echocardiography were performed. A total of 100 consecutive IDMs examined. The most common echocardiographic findings were patent ductus arteriosus (PDA; 70%), patent foramen ovale (68%), atrial septal defect (5%), small muscular ventricular septal defect (4%), mitral valve prolapse (2%), and pulmonary stenosis (1%). Hypertrophic cardiomyopathy (HCMP) was observed in 38% of cases, mainly hypertrophy of the interventricular septum. Severe forms of CHD encountered were D-transposition of great arteries, tetralogy of Fallot, and hypoplastic left heart syndrome (1% each). Isolated aortic stenosis and coarctation of aorta were not encountered in this series. Overall incidence of congenital heart disease was 15% after excluding PDA and HCMP. Maternal IDDM is a significant risk factor for CHD. Careful evaluation and early diagnosis of CHD in this high-risk group are highly indicated. There is a need for development of prenatal screening programs for CHD in our population.
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AA Alabdulgader (2001) ArticleTitle. Ann Trop Paediatr 21 111–118 Occurrence Handle1:STN:280:DC%2BD3MvisVaksw%3D%3D Occurrence Handle11471253
SM Becker Z Al Halees R Paterson (2001) ArticleTitleConsanguinity and congenital heart disease in Saudi Arabia. Am J Med Genet 99 8–14 Occurrence Handle10.1002/1096-8628(20010215)99:1<8::AID-AJMG1116>3.0.CO;2-U Occurrence Handle1:STN:280:DC%2BD3MzgtV2itg%3D%3D Occurrence Handle11170087
CS Chung NC Myrianthopos (1975) ArticleTitleEffects of maternal diabetes on congenital malformations. Birth Defects 11 23–58 Occurrence Handle1:STN:280:CSmC287nvFY%3D
JM Criley PL Lennon AS Abbasi (1976) In: Levine H (ed) Clinical cardiovascular physiology. Grune and Stratton New York 771–827
C Ferencz (1990) A case-control study of cardiovascular malformation in live born infants: the morphogenic relevance of epidemiological findings. EB Clark A Takao (Eds) Developmental cardiology: Morphogenesis and funcion. Future Mount Kisco, NY 523–539
C Fernecz JD Rubin RJ McCarter EB Clark et al. (1990) ArticleTitleMaternal diabetes and cardiovascular malformations: Predominance of double-outlet right ventricle and truncus arteriosus. Teratology 41 319–326 Occurrence Handle1:STN:280:By%2BB38zjt1U%3D Occurrence Handle2326756
G Gladman B McCrindle C Boutin J Smallhorn (1997) ArticleTitleFetal echocardiographic screening of diabetic pregnancies for congenital heart disease. Am J Perinat 14 IssueID2 59–62 Occurrence Handle1:STN:280:ByiH3cnksFU%3D
JA Goldman D Dicker D Feldberg et al. (1986) ArticleTitlePregnancy outcome in patients with insulin-dependant diabetes mellitus with preconception diabetic control: A comparative study. Am J Obstet Gynecol 155 293–297
HP Gutgesell CE Mullins PC Gillette et al. (1976) ArticleTitleTransient hypertrophic subaortic stenosis in infants of diabetic mothers. J Pediatr 89 120–125 Occurrence Handle1:STN:280:CSmB3MnptFU%3D Occurrence Handle945337
OP Heinonen (1976) Risk factors for congenital heart disease: A prospective study. S Klell (Eds) Birth defects, risks and consequences. Academic Press New York 221–264
JL Kitzmiller JP Cloherty MD Younger et al. (1978) ArticleTitleDiabetic pregnancy and perinatal morbidity. Am J Obstet Gynecol 131 560 Occurrence Handle1:STN:280:CSeB3s3nslU%3D Occurrence Handle354386
BJ Maron CE Clark SE Epstein (1977) ArticleTitleAsymmetric septal hypertrophy: Echocardiographic identification of the pathognomonic anatomic abnormality of IHSS. Circulation 47 233
BJ Maron JE Edward WL Henry et al. (1974) ArticleTitleAsymmetric septal hypertrophy in infancy. Circulation 50 809
MT Menutti (1985) ArticleTitleTetratology and genetic counseling in the diabetic pregnancy. Clin Obstet Gynecol 28 486–495 Occurrence Handle2414047
E Miller JW Hare JP Cloherty et al. (1981) ArticleTitleElevated maternal hemoglobin A1c in early pregnancy and major congenital anomalies in infants of diabetic mothers. N Engl J Med 304 1331–1334 Occurrence Handle1:STN:280:Bi6C2s3ptFI%3D Occurrence Handle7012627
J Mills R Knopp J Simpson et al. (1988) ArticleTitleLack of relation of increased malformation rate in infants of diabetic mothers to glycemic control during organgenesis. N Engl J Med 318 671–676 Occurrence Handle1:STN:280:BieC2czgt1I%3D Occurrence Handle3344018
JL Mills L Baker AS Goldman (1979) ArticleTitleMalformations in infants of diabetic mothers occur before the seventh gestational week: Implications for treatment. Diabetes 28 292–293
JL Mills (1982) ArticleTitleMalformations in infants of diabetic mothers. Teratology 25 385–394 Occurrence Handle1:STN:280:Bi2B2sjptFY%3D Occurrence Handle7051398
MD Reller RC Tsang RA Meyer et al. (1985) ArticleTitleRelationship of prospective diabetes control in pregnancy to neonatal cardiorespiratory function. J Pediatr 106 86–90 Occurrence Handle1:STN:280:BiqD1c3kvVA%3D Occurrence Handle3880822
TW Rowland JP Hubbell AS Nadas (1973) ArticleTitleCongenital heart disease in infants of diabetic mothers. J Pediatr (Nov.) . 815–820
LE Shields EA Gan HF Murphy et al. (1993) ArticleTitleThe prognostic value of hemoglobin A1c in predicting fetal heart disease in diabetic pregnancies. Obstet Gynecol 81 954–957
NG Soler SM Soler JM Malins (1978) ArticleTitleNeonatal morbidity among infants of diabetic mothers. Diabetes Care 1 390
GL Way RR Wolfe E Eshagpour et al. (1979) ArticleTitleThe natural history of Hypertrophic cardiomyopathy in infants of diabetic mothers. J Pediatr 95 1020–1025 Occurrence Handle1:STN:280:Bi%2BD2M7kslI%3D Occurrence Handle159352
HS Weber JA Copel EA Reece et al. (1991) ArticleTitleCardiac growth in fetuses of diabetic mothers with good metabolic control. J Pediatr 118 103–110 Occurrence Handle1:STN:280:By6D1Mzos1M%3D Occurrence Handle1986073
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Abu-Sulaiman, R., Subaih, B. Congenital Heart Disease in Infants of Diabetic Mothers: Echocardiographic Study . Pediatr Cardiol 25, 137–140 (2004). https://doi.org/10.1007/s00246-003-0538-8
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DOI: https://doi.org/10.1007/s00246-003-0538-8