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RESEARCH PRODUCT
Transitional hemodynamics in infants of diabetic mothers by targeted neonatal echocardiography, electrocardiography and peripheral flow study
Giovanni CorselloSimona La PlacaGiuseppa PinelloIngrid Anne Mandy SchierzEttore PiroMario Giuffrèsubject
AdultMaleDoppler-echocardiographyPediatricsmedicine.medical_specialtycerebrovascular circulation; Doppler-echocardiography; glucose metabolism disorders; heart function; Observational case-control study; Pediatrics Perinatology and Child Health; Obstetrics and GynecologyHemodynamics030204 cardiovascular system & hematologyDoppler echocardiographyElectrocardiography03 medical and health sciencesheart function0302 clinical medicineObstetrics and gynaecologyPregnancyglucose metabolism disorderDiabetes mellitusmedicineHumansObservational case-control studyFetus030219 obstetrics & reproductive medicinemedicine.diagnostic_testbusiness.industryfungiInfant Newbornfood and beveragesObstetrics and GynecologyHeartmedicine.diseaseCerebrovascular CirculationPeripheralDiabetes GestationalEchocardiographyCase-Control StudiesPediatrics Perinatology and Child Healthcardiovascular systemFemalecerebrovascular circulationbusinessElectrocardiographyBlood Flow Velocitydescription
Objective: Metabolic alterations of intrauterine environment in diabetes mellitus (DM) lead to fetal cardiac dysfunctions that can persist after birth. The aim of the study was to assess the cardiovascular adaptation in infants born to diabetic mothers (IDM) with different degrees of glycometabolic control, in relation to revised guidelines for diagnosis of DM and quality improvements in neonatal care. Materials and methods: An observational case-control study was conducted on IDM with gestational, type 1 and type 2âDM. Relevant maternal and neonatal anamnestic, clinical and laboratory data were analyzed. Electrocardiographic and echocardiographic analyses, including structural and systo-diastolic evaluation, were performed. Results: In 68 IDM enrolled, we observed a lower incidence of negative perinatal outcome than expected. Comparing to non-IDM, they presented larger fetal shunts, higher pulmonary pressures, early and atrial wave velocities. At 72âhours, kinesis and heart rate variability remained low. Cerebral blood flow velocities were higher. The most serious impairment of transition was in pregestational IDM. Conclusion: Maternal DM impaired neonatal transitional hemodynamics also in asymptomatic IDM with good glycometabolic control. These results confirm the need for an early cardiologic and cerebrovascular evaluation, to identify IDM with delayed maturation at risk of worse long-term metabolic, cardiovascular, and neurodevelopmental outcome.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2017-05-05 |