Abstract
Background: The risk of congenital anomalies is increased in infants of diabetic mothers (IDM). The most frequent cardiac anomalies in IDMs include ventricular septal defect, transposition of great arteries, and aortic stenosis.Objective: Estimating the incidence of infants with congenital heart defects (CHD) whose mothers have diabetes in Saudi Arabia at a tertiary hospital in the National Guard Health Affairs (NGHA) system.Materials and methods: This study was a retrospective cohort. The population was all births of type 1 and type 2 diabetic mothers and non-diabetic mothers (also mothers with gestational diabetes) in NGHA by following the exclusion criteria, which were mothers over 40 and below 20 years of age, and other risk factors such as drug-induced congenital disease. The data was from deliveries from January 1st 2018 to January 1st 2019. Data were collected by chart review using the Best-Care system at NGHA hospital. Statistical Package for the Social Sciences (SPSS) version 20 (IBM Corp., Armonk, NY, USA) was used for the statistical analysis.Results: A total of 1838 diabetic mothers and non-exposure, non-diabetic mothers, with the outcome of whether the infant had CHD, were included in this study. Most of the mothers (544, 30.11%) were aged 30-34 years old. About two-thirds of mothers, 1161 (63.24%), weren't diabetic, 500 (27.23%) had gestational diabetes, 132 (7.19%) were type 2 diabetes (T2DM), and 43 (2.34%) were type 1 diabetes (T1DM). Two hundred eighteen (11.82%) offspring had CHD, and the remaining 1625 (88.17%) did not. The most frequent echocardiographic abnormalities in infants of diabetic mothers were patent ductus arteriosus (PDA) (31.75%), patent foramen ovale (PFO) (31.75%), and atrial septal defect (ASD) (23.64%).Conclusion: The incidence of CHD among infants of included mothers in this cohort study was 11.82%. The most frequent echocardiographic abnormalities in the infants of diabetics were PDA and PFO. The incidence of CHD was higher among mothers who had T1DM followed by T2DM, and whose ages were between 30-34.
Highlights
Cardiovascular disease (CVD) is the major cause of mortality and morbidity worldwide [1]
A total of 1838 diabetic mothers and non-exposure, non-diabetic mothers, with the outcome of whether the infant had congenital heart defects (CHD) were included in this study
The incidence of CHD among infants of included mothers in this cohort study was 11.82%; similar studies were conducted by Alabdulgader et al in the eastern province of Saudi Arabia [14] and Muhammad et al in Peshawar-Pakistan [15] where they reported a lower incidence of CHD among infants, which was 10.7% and 9.3% respectively
Summary
Cardiovascular disease (CVD) is the major cause of mortality and morbidity worldwide [1]. The risk factors for CVD change throughout a lifetime and early onset CVD could have a different reason than CVD diagnosed in later adulthood [4]. Prenatal susceptibility to maternal diabetes has been correlated with obesity, congenital heart disease (CHD), and diabetes in offspring. These diseases could lead to an increased risk of CVD in later life [5]. The risk of congenital anomalies is increased in infants of diabetic mothers (IDM). The most frequent cardiac anomalies in IDMs include ventricular septal defect, transposition of great arteries, and aortic stenosis
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