Frequency and Pattern of Congenital Heart Defects in Infant of Diabetic Mother at Tertiary Care Hospital

Abstract

Objective: This study was conducted to evaluate the frequency and pattern of congenital heart defects in the infant of pregestational and gestational diabetic mothers presenting at NICU and the causality department of NICH Karachi Pakistan. Methods: It was a cross-sectional study conducted at NICH Karachi, from July to Oct 2022. Infants born to diabetic mothers were enrolled in the study and the frequency and pattern of congenital heart diseases were determined by echocardiography which was performed by a pediatric cardiologist who has had expertise in his field for more than 10 years. Results: A total of 147 infants were enrolled in the study with the majority of them being 0 to 15 days of age (n=138, 93.9%) and were male gender (n=88, 59.9%). Nearly a quarter of mothers had pre-gestational diabetes (n=35, 23.8%) while 112 (76.2%) mothers had gestational diabetes. Out of 147, 67 (45.57%) infants had congenital heart defects. The most common heart defect was PFO (n=35, 23%) followed by PDA (n=22, 14.9%), VSD (n=8, 5.4%), ASD (n=4, 2.7%), HCM (n=4, 2.7%), TOF (n=4, 2.7%) and TGA (n=2, 1.36%). A significant difference was seen for ASD (p<0.001), VSD (p<0.001), TGA (p=0.011), HCM (p<0.001), and TOF (p<0.001) in congenital heart defect among infants born to mother having pre-gestational diabetes and gestational diabetes. Conclusion: This study analyzed that nearly half of the infants born to diabetic mothers had congenital heart defects. Thus, it highlights a need for the development of postnatal screening programs for CHD in our population for managing this problem timely. To reduce morbidity and mortality, early CHD diagnosis with screening echocardiography is advised.