672 No Suggestion of Cardiac Hypertrophy or Dysfunction in Infants Born to Mothers With Gestational Diabetes

Abstract

Infants of mothers with gestational diabetes (GDM) are known to be at greater long-term risk of cardiovascular disease and have been observed to exhibit a cardiac phenotype similar to that of hypertrophic cardiomyopathy with associated systolic and diastolic function. The available literature concerning diabetes-associated neonatal cardiomyopathy has a heterogeneity of methodology and inconsistently reports clinically-significant cardiac dysfunction in these infants. Mothers were recruited antenatally or post-birth. Inclusion criteria were singleton, term pregnancies with no identified fetal chromosomal abnormality. Focussed cardiac ultrasound was performed on neonates within 72hrs of birth. 157 neonates were included (infant of GDM mother n=79, 50%). The mean age of mothers was 29.93±4.98 years old and 50% were nulliparous. Maternal and neonatal characteristics were similar. No neonates demonstrated any clinical or ultrasound markers of hypertrophic cardiomyopathy, and indexed septal and left ventricular posterior wall thicknesses (in both systole and diastole) were similar between groups. Tricuspid and mitral valve inflow velocities were also similar. Additionally, both groups of neonates had similar LV shortening fraction, LV ejection fraction, and tricuspid annular plane systolic excursion (TAPSE). The myocardial performance index (Tei index) demonstrated adequate global cardiac function in both groups. Reassuringly, there is no suggestion of significant cardiac dysfunction or hypertrophy in this population neonates born to mothers with GDM. A referral to tertiary cardiac services should only be made when there is valid suspicion for congenital heart disease.