SUBCLINICAL POSTNATAL CARDIAC CHANGES IN ASYMPTOMATIC INFANTS OF DIABETIC MOTHERS | ||||
| Al-Azhar Journal of Pediatrics | ||||
| Article 8, Volume 26, Issue 1, January 2023, Page 3219-3231 PDF (144.24 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/azjp.2023.287915 | ||||
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| Abstract | ||||
| Background: Maternal diabetes mellitus carries several significant risks to the fetal heart, even in the absence of structural abnormalities. Objectives: To compare cardiac functions in asymptomatic infants born to mothers either with gestational diabetes (GDM) or pregestational diabetes (PGDM) and to observe changes in the cardiac functions in both groups over the first three months of life. Patients and Methods: The current study was a prospective cohort that was conducted in Ain Shams University Children's Hospital Pediatric Cardiology Unit in conjunction with Obstetrics and Gynecology Hospital Outpatient Clinic during the period between January 2018 till June 2018. The study included forty-five infants born to mothers with diabetes; IGDM (Group 1) 13 patients (29%) and IPGDM (Group 2) 32 patients (71%). Transthoracic echocardiography was done to assess systolic functions and diastolic functions. The IDMs were compared to thirty healthy age and sex-matched controls. Results: After delivery, no significant difference was observed in cardiac dimensions or systolic functions between cases and controls. However, diastolic functions seemed to be worse in IDMs with significantly longer Tei index (p = 0.014) and lower E' (p = 0.015) and A' velocities (p=0.049). At one month follow-up, infants of PGDM mothers showed worse cardiac functions shown by worse Ejection Fraction (EF) (p = 0.004), Fractional shortening (FS) (p =0.003), Global Longitudinal strain (GLS) (p =0.002) and prolonged Tei index (p=0.004). These differences diminished at three months of follow-ups. Conclusion: Asymptomatic infants of diabetic mothers may have diastolic dysfunction despite normal cardiac dimensions and normal systolic functions. Infants of pre-gestational diabetes have worse cardiac functions at one month of age compared to infants of gestational DM mothers. These differences in myocardial functions diminish at three months | ||||
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