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European Heart Journal Advance Access published online on December 11, 2006
European Heart Journal, doi:10.1093/eurheartj/ehl416
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© The European Society of Cardiology 2006. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Pathologic ventricular hypertrophy in the offspring of diabetic mothers: a retrospective study

Sandra Ullmo1, Yvan Vial2, Stefano Di Bernardo1, Matthias Roth-Kleiner3, Yvan Mivelaz1, Nicole Sekarski1, Juan Ruiz4 and Erik J Meijboom1,*

1 Department of Paediatric Cardiology, Centre Hospitalier Universitaire Vaudois, BH 11–626, Rue du Bugnon 46, 1011 Lausanne, Switzerland
2 Department of Gynaecology and Obstetrics, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
3 Department of Neonatology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
4 Department of Endocrinology, Diabetology, and Metabolism, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland

Received 3 August 2006; revised 11 August 2006; accepted 16 November 2006.

* Corresponding author. Tel: +41 21 314 3553; fax: +41 21 314 3665. E-mail address: Erik.Meijboom{at}chuv.ch

Aims Diabetes in pregnant women is increasing and with that the complications in their offspring. We studied our population of diabetic mothers (2003–2005) for pathologic ventricular hypertrophy (PVH).

Methods and results In our retrospective study of all 87 diabetic pregnancies (92 neonates), 16 were type 1, 17 were type 2, and 54 were gestational diabetes (GD). Haemoglobin glycated (HbA1c) median was 5.8% (5.3–6.5): 17 with HbA1c above normal 2 with congenital heart disease (CHD) and six with PVH. A total of 75 neonates were normal, five had CHD, and 12 had PVH (1/12 died post-natally, 1/12 stillborn, 2/12 required premature delivery, 8/12 normal). The 16 type 1 pregnancies resulted in three neonates with CHD and in 50% PVH, including one death, one premature Cesarean section because of PVH. The 17 neonates of type 2 pregnancies showed in one CHD and in 25% PVH. Of the 54 GD pregnancies, one had CHD and one had PVH.

Conclusion Pregnancies of both type 1 and 2 diabetes carry an increased risk for foetal development of PVH compared with those with GD. The insufficient effect of preventive glycaemia controls leads to conclude that although no definite predictive parameters for malignant outcome can be presented, close monitoring of these pregnancies may prevent perinatal catastrophes.

Key Words: Maternal diabetes • Fetal cardiopathy • Pathologic ventricular hypertrophy • Hypertrophic cardiomyopathy • Echocardiography


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