Cardiac Malformations in Fetuses of Gestational and Pre Gestational Diabetic Mothers

AUTHORS

Nooshin Shirzad 1 , * , Avisa Tabib 2 , Sara Sheikhbahaei 3 , Sara Mohammadi 4 , Mostafa Qorbani 5 , Vahid Haghpanah 6 , Farzaneh Abbasi 7 , Shirin Hasani-Ranjbar 8 , Ramin Baghaei-Tehrani 9

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How to Cite: Shirzad N, Tabib A, Sheikhbahaei S, Mohammadi S, Qorbani M, et al. Cardiac Malformations in Fetuses of Gestational and Pre Gestational Diabetic Mothers, Iran J Pediatr. 2013 ; 23(6):664-668.

ARTICLE INFORMATION

Iranian Journal of Pediatrics: 23 (6); 664-668
Published Online: November 23, 2013
Article Type: Research Article
Received: May 17, 2013
Accepted: October 10, 2013

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Abstract

Objective: In this study we aimed to determine the prevalence of cardiac malformations in fetuses of Iranian diabetic mothers with pre-gestational and gestational diabetes mellitus (GDM) and to find the patterns of different cardiac malformations. Methods: One-hundred and seventy diabetic pregnant women (68 preGDM and 102 GDM) (mean age: 32.17±4.8 years) and 85 healthy controls (mean age: 31.35±4.55 years) were recruited from September 2008 to July 2012. Fetal echocardiography was performed to assess cardiac malformation. In order to study major factors that may affect the results, a complete history was obtained. Findings: Fetal echocardiography was performed at mean gestational age of 24.7±5.4 and 20.27±3.9 weeks in diabetic patients and control group, respectively. Fifteen (8.8%) fetuses of diabetic mothers were detected to have cardiac malformations compared with 1 (1.17%) fetus in control group (OR: 8.13, 95%CI: 1.1-62.61,      P-value=0.02). Hypertrophic cardiomyopathy noted as the most common cardiac malformation occurred in 6 out of 15 (40%) fetuses, and was found significantly more common in pre-GDM compared to GDM group (7.4% vs 1%, P-value =0.04). Despite the higher incidence of cardiac malformation in pre-GDM compared to GDM group, the difference was not significant. Further, no significant association was observed between the variables including; parity, diabetic regimen, parents’ consanguinity, maternal history of hypertension or hypothyroidism and occurring cardiac malformations (P-value >0.05). Conclusion: In this study we detected cardiac malformations in 8.8% of our diabetic referrals. The result of the present study shows that screening diabetic mothers for fetal cardiac malformations could be beneficial.

 

Keywords

Congenital Heart Disease Diabetes Mellitus Gestational Diabetes Mellitus

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