Congenital heart disease in pregnancies complicated by maternal diabetes mellitus. An international clinical collaboration, literature review, and meta-analysis.

Details

Serval ID
serval:BIB_06375D863ABC
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Congenital heart disease in pregnancies complicated by maternal diabetes mellitus. An international clinical collaboration, literature review, and meta-analysis.
Journal
Herz
Author(s)
Lisowski Lukas A., Verheijen Paul M., Copel Joshua A., Kleinman Charles S., Wassink Sander, Visser Gerard H.A., Meijboom Erik-Jan
ISSN
1615-6692[electronic], 0340-9937[linking]
Publication state
Published
Issued date
2010
Volume
35
Number
1
Pages
19-26
Language
english
Abstract
PURPOSE: Investigation of the incidence and distribution of congenital structural cardiac malformations among the offspring of mothers with diabetes type 1 and of the influence of periconceptional glycemic control. METHODS: Multicenter retrospective clinical study, literature review, and meta-analysis. The incidence and pattern of congenital heart disease in the own study population and in the literature on the offspring of type 1 diabetic mothers were compared with the incidence and spectrum of the various cardiovascular defects in the offspring of nondiabetic mothers as registered by EUROCAT Northern Netherlands. Medical records were, in addition, reviewed for HbA(1c) during the 1st trimester. RESULTS: The distribution of congenital heart anomalies in the own diabetic study population was in accordance with the distribution encountered in the literature. This distribution differed considerably from that in the nondiabetic population. Approximately half the cardiovascular defects were conotruncal anomalies. The authors' study demonstrated a remarkable increase in the likelihood of visceral heterotaxia and variants of single ventricle among these patients. As expected, elevated HbA(1c) values during the 1st trimester were associated with offspring fetal cardiovascular defects. CONCLUSION: This study shows an increased likelihood of specific heart anomalies, namely transposition of the great arteries, persistent truncus arteriosus, visceral heterotaxia and single ventricle, among offspring of diabetic mothers. This suggests a profound teratogenic effect at a very early stage in cardiogenesis. The study emphasizes the frequency with which the offspring of diabetes-complicated pregnancies suffer from complex forms of congenital heart disease. Pregnancies with poor 1st-trimester glycemic control are more prone to the presence of fetal heart disease.
Keywords
Congenital Heart Disease, Periconceptional Glycemic Control, Congenital Structural Cardiac Malformations, Outlet Right Ventricle, Left-Right Asymmetry, Fetal-Growth Delay, Glycemic Control, Great-Arteries, Birth-Defects, Cardiovascular Malformations, Spontaneous-Abortion, Prenatal-Diagnosis, Vitamin-E
Pubmed
Web of science
Create date
24/02/2010 10:35
Last modification date
20/08/2019 12:28
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