Heart changes in a fetus of a diabetic mother

Pabis, Julia Simões; Schneider, Leticia; Stoll, Luisa F; Simões, Mona Adalgisa

doi:10.15761/tdm.1000108

Cited by 2 publications

(2 citation statements)

References 8 publications

(9 reference statements)

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“…The main structural alteration in the foetus of a pregnant diabetic mother is myocardial hypertrophy which can lead to transient subaortic stenosis and occasionally causes congestive heart failure (CHF). Chronic foetal hyperinsulinemia causes foetal macrosomia and increases the cardiac mass due to a larger mass of myocardial nuclei, increased cell number, and hypertrophy of myocardial fibres secondary to an increase in the synthesis of proteins and fats, independent of the amount of glycogen deposition, resulting from the increased presence of insulin receptors in the foetal heart[ 29 ]. Hypertrophic cardiomyopathy (HCM) is the most common cardiac malformation in up to 40% of diabetic pregnancies.…”

Section: Effect Of Diabetes On the Heart Of Foetus And Offspring Of Diabetic Mothersmentioning

confidence: 99%

Cardiac changes in infants of diabetic mothers

Al‐Biltagi

Razaky

Amrousy

2021

WJD

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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.

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Section: Effect Of Diabetes On the Heart Of Foetus And Offspring Of Diabetic Mothersmentioning

confidence: 99%

Cardiac changes in infants of diabetic mothers

Al‐Biltagi

Razaky

Amrousy

2021

WJD

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“…In fact, up to 40% of IDMs develop CH [ 21 ], and one of its most important etiological factors is fetal hyperinsulinemia induced by the chronic hyperglycemia that causes hypertrophy of the insulin-sensitive tissues, including the heart, and increased expression and affinity of insulin receptors [ 26 ]. Thus, chronic fetal hyperinsulinemia can trigger CH by increasing myocardial nuclei and cell number, and inducing hypertrophy of myocardial fibers by promoting protein and fat synthesis in cardiomyocytes [ 27 ]. These insulin effects could be potentiated in extremely preterm infants by the high fetal proliferative capacity of immature cardiomyocytes [ 28 ].…”

Section: Discussionmentioning

confidence: 99%

Cardiac Hypertrophy Associated with Insulin Therapy in Extremely Preterm Infants

et al. 2023

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Background In the neonatal period, cardiac hypertrophy (CH) has been commonly associated with hyperinsulinemic pathologies, and the first case of CH in an extremely preterm infant treated with insulin infusion has recently been reported. To confirm this association, we report a case series of patients who developed CH after insulin therapy. Methods Infants with gestational age < 30 weeks and birth weight < 1500 g, born from November 2017 to June 2022, were studied if they developed hyperglycemia requiring treatment with insulin and had echocardiographic diagnosis of CH. Results We studied 10 extremely preterm infants (24.3 ± 1.4 weeks) who developed CH at a mean age of 124 ± 37 h of life, 98 ± 24 h after the initiation of insulin therapy. All surviving patients had resolution of CH at discharge, while three of four (75%) of the deceased patients had persistent CH. Conclusions Our case series supports the association between the development of CH and insulin therapy in extremely preterm infants and suggests further caution and the need for echocardiographic monitoring when treating these fragile patients with insulin.

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Heart changes in a fetus of a diabetic mother

Cited by 2 publications

References 8 publications

Cardiac changes in infants of diabetic mothers

Cardiac changes in infants of diabetic mothers

Cardiac Hypertrophy Associated with Insulin Therapy in Extremely Preterm Infants

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