Authors
1 Assistant Professor of pediatric cardiology ,Physiology Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran
2 Ph.D. Candidate in Epidemiology, Endocrinology and Metabolism Research Center, Institute of Basic and Clinical Physiology Sciences, Kerman University of Medical Sciences Kerman, Iran
3 Professor of Neonatology, Gastroenterology and Hepatology Research Center, Institute of Basic and Clinical Physiology Sciences, Kerman University of Medical Sciences, Kerman, Iran
4 Clinical Research Unit, Afzalipour Hospital, Kerman University of Medical Sciences, Kerman, Iran
Abstract
Background: The prevalence of gestational diabetes mellitus is rising. Myocardial hypertrophy is the most common cardiac disorder in the infants of diabetic mothers, which hypothetically can cause fatal arrhythmias. This study investigated prolonged QT in the newborns of diabetic mothers in Afzalipour Hospital in Kerman City, in 2015.
Methods: This case-control study was conducted on 49 neonates of diabetic mothers and 30 babies of healthy mothers. Routine echocardiograms and Tissue Doppler Imaging (TDI) were performed for all the newborns. QTc values were computed from randomly selected beats on ECG.
Results: Twenty-nine (59%) newborns in case group had septal hypertrophy which was higher than control group (P < 0.05). There was no difference between case and control groups in QTc values (P > 0.05), and there was no relationship between septal hypertrophy and QT prolongation. Twenty-one percent of the infants in control group, had septal hypertrophy. Although parameters of M-Mode Echocardiography were similar, TDI showed differences between the two groups. (TDI) is applicable for the measurement of both systolic and diastolic functions.
Conclusion: Findings revealed that the screening and treatment of diabetes during pregnancy need a revision in our context. In addition, there is a paucity of studies concerning the evaluation of TDI in the newborns of diabetic mothers. We recommend conducting studies to compare the routine echocardiograms with TDI in these high risk infants.
Keywords
- Carlo WA. Chapter 101.1. Infants of diabetic mothers. In: Kliegman RM, Stanton BF, St. Geme JW, Schor NF, Behrman RE, editors. Nelson textbook of pediatrics. 19th ed. Philadelphia: Saunders Elsevier; 2012. pp. 627-629.
- Martin RJ, Fanaroff AA, Walsh MC. Fanaroff and Martin's Neonatal-Perinatal Medicine. 10th ed. Netherlands: Elsevier; 2015.
- Jovanovic L, Pettitt DJ. Gestational diabetes mellitus. JAMA 2001; 286(20):2516-8.
- Soheilikhah S, Mogibian M, Rahimi-Saghand S, Rahimi M, Soheilykhah S, Piroz M. Incidence of diabetes gestationaal daibetes mellitus in pregnant women. Iranian Journal of Reproductive Medicine 2010; 8(2):24-8.
- Kim C, Newton KM, Knopp RH. Gestational diabetes and the incidence of type 2 diabetes: a systematic review. Diabetes Care 2002; 25(10):1862-8.
- Chu C, Gui YH, Ren YY, Shi LY. The impacts of maternal Gestational Diabetes Mellitus (GDM) on fetal hearts. Biomed Environ Sci 2012; 25(1):15-22.
- Krishnaveni GV, Hill JC, Leary SD, Veena SR, Saperia J, Saroja A, et al. Anthropometry, glucose tolerance, and insulin concentrations in Indian children: relationships to maternal glucose and insulin concentrations during pregnancy. Diabetes Care 2005; 28(12):2919-25.
- Jaeggi ET, Fouron JC, Proulx F. Fetal cardiac performance in uncomplicated and well-controlled maternal type I diabetes. Ultrasound Obstet Gynecol 2001; 17(4):311-5.
- Kliegman R, Nelson WE. Nelson Textbook of Pediatrics. 19th ed. Philadelphia: Elsevier, Saunders; 2011.P. 1632.
- Cooper MJ, Enderlein MA, Tarnoff H, Roge CL. Asymmetric septal hypertrophy in infants of diabetic mothers. Fetal echocardiography and the impact of maternal diabetic control. Am J Dis Child 1992; 146(2):226-9.
- Russell NE, Foley M, Kinsley BT, Firth RG, Coffey M, McAuliffe FM. Effect of pregestational diabetes mellitus on fetal cardiac function and structure. Am J Obstet Gynecol 2008; 199(3):312 e1-7.
- Arslan D, Guvenc O, Cimen D, Ulu H, Oran B. Prolonged QT dispersion in the infants of diabetic mothers. Pediatr Cardiol 2014; 35(6):1052-6.
- Tabib A, Shirzad N, Sheikhbahaei S, Mohammadi S, Qorbani M, Haghpanah V, et al. Cardiac malformations in fetuses of gestational and pre gestational diabetic mothers. Iran J Pediatr 2013; 23(6):664-8.
- Lai WW, Mertens LL, Geva T, Cohen MS. Echocardiography in Pediatric and Congenital Heart Disease: From Fetus to Adult. 2nd ed. USA: Wiley; 2012.
)