Poster Presentation Australasian Diabetes in Pregnancy Society Annual Scientific Meeting 2019

No Suggestion of Interventricular Wall Hypertrophy in Infants Born to Diabetic Mothers Compared to Controls (#50)

Kaitlyn KH Hockey 1 , David DS Simmons 1 , John JW Whitehall 1
  1. Western Sydney University, Campbelltown, NSW, Australia

Aims

 This aim of this study was to compare echocardiography-measured cardiac structures in neonates born to women with and without gestational diabetes (GDM)

Methods

Inclusion criteria were singleton pregnancy born at > 36+0 weeks gestation. Exclusion criteria were prematurity, multiple pregnancy, illicit drug use during pregnancy, or known significant structural or chromosomal abnormality. Women were recruited in the antenatal diabetes in pregnancy clinics or in maternity post-natally. Mothers were provided with an information sheet and written consent was obtained. Neonatal echocardiography clips and still images acquired using the Sonosite X-PORTE point-of-care ultrasound system and a phased array 6-8MHz transducer. The examination was performed on neonates within the first 72 hours of life. Interventricular septum (IVS) dimensions were taken using M-mode in the parasternal window, in a line perpendicular to the mitral leaflet tips. Functional measures were derived from pulsed-wave Doppler measurements and TAPSE (tricuspid annular plane systolic excursion).

Results

107 women were recruited with age 30.5±5.1 years, BMI 28.1±6.0 kg/m2 and parity 0.83±1.1. Analysis of cardiac variables found no significant difference between the IDM or control groups.

 

 IDM Group (n=47)

Control Group (n=60) 

  

Maternal HbA1c %

5.38

not measured

  

 IVS (diastole) Z-score

-0.34 (-1.16 - 0.48) 

 -0.12 (-0.82 - 0.58)

N.S.

Left Ventricle Myocardial Performance Index 

0.63 (0.56 - 0.71) 

 0.64 (0.58 - 0.70)

N.S.

TAPSE Z-score

0.35 (-0.37 - 1.09)

-0.06 (-0.50 - 0.38)

 N.S.


Results show mean and 95% confidence interval.

Conclusions

The lack of septal hypertrophy similar functional measures in the IDM group is a reassuring sign and corroborates some of the existing literature. However, some studies have found a septal hypertrophy in these neonates1 and more research is needed to confirm the prevalence and clinical severity of this phenotype. Currently, it is recommended that care of the newborn should only be escalated in the case of a murmur or other clinical signs of cardiac disease2.

  1. Cimen, D. and Karaaslan, S. (2014). Evaluation of cardiac functions of infants of diabetic mothers using tissue Doppler echocardiography. Türk Pediatri Arşivi, 49(1), pp.25-29.
  2. National Institute for Health and Care Excellence. (2015, February 25). Diabetes in pregnancy: Management of diabetes and its complications. London: NICE. Retrieved from National Institute for Health and Care Excellence.