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Review
. 2021 Aug 15;12(8):1233-1247.
doi: 10.4239/wjd.v12.i8.1233.

Cardiac changes in infants of diabetic mothers

Mohammed Al-Biltagi  1 , Osama El Razaky  1 , Doaa El Amrousy  1
Affiliations
Review

Cardiac changes in infants of diabetic mothers

Mohammed Al-Biltagi et al. World J Diabetes. .

Abstract

Diabetes mellitus (DM) is a systemic chronic metabolic disorder characterized by increased insulin resistance and/or β- cell defects. It affects all ages from the foetal life, neonates, childhood to late adulthood. Gestational diabetes is a critical risk factor for congenital heart diseases (CHDs). Moreover, the risk increases with low maternal education, high body mass index at conception, undiagnosed pre-gestational diabetes, inadequate antenatal care, improper diabetes control, and maternal smoking during pregnancy. Maternal DM significantly affects the foetal heart and foetal-placental circulation in both structure and function. Cardiac defects, myocardial hypertrophy are three times more prevalent in infants of diabetic mothers (IDMs). Antenatal evaluation of the cardiac function and structures can be performed with foetal electrocardiography and echocardiography. Postnatal cardiac evaluation can be performed with natal and postnatal electrocardiography and echocardiography, detection of early atherosclerotic changes by measuring aortic intima-media thickness, and retinal vascular changes by retinal photography. Ameliorating the effects of diabetes during pregnancy on the offspring depends mainly on pregestational and gestational diabetes prevention. However, other measures to reduce the risk, such as using medications, nutritional supplements, or probiotics, still need more research. This review discusses the mechanism of foetal sequels and the risk factors that increase the prevalence of CHDs in gestational DM, the various cardiac outcomes of gestational DM on the foetus and offspring, cardiac evaluation of foetuses and IDMs, and how to alleviate the consequences of gestational DM on the offspring.

Keywords: Children; Congenital heart diseases; Echocardiography; Gestational diabetes mellitus; Hypertrophic cardiomyopathy; Infants of diabetic mother.

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Conflict of interest statement

Conflict-of-interest statement: The authors declare that they have no conflict of interests related to this article.

Figures

Figure 1
Figure 1
Possible mechanisms of foetal cardiac damage in gestational diabetes. IGF-І: insulin-like growth factor-І.
Figure 2
Figure 2
Diagrammatic representation of normal heart (A) and heart with left ventricular hypertrophy, anatomical, 2-D, and M-mode (B). IVS: Interventricular septum; LA: Left atrium; LV: Left ventricle; LV (D): Left ventricular diameter; LV PSW: Left ventricular posterior wall.
Figure 3
Figure 3
The figure showed normal 2-D and M-mode from a normal infant (A) and showed septal hypertrophy in an infant of a diabetic mother (B).
See this image and copyright information in PMC

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