Maternal diabetes and the fetal heart

Hornberger, Lisa K.

doi:10.1136/hrt.2005.083840

Cited by 92 publications

(91 citation statements)

References 31 publications

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“…Cardiovascular pathology may even evolve as a consequence of the abnormal intrauterine milieu. The lesions that best represents the latter is hypertrophic cardiomyopathy observed in the diabetic pregnancy which may be observed even in the late first, early second trimester [93], and we have recently found to persist even in late infancy (unpublished data). The recipient twin in twin-twin transfusion syndrome, as well, develops increased medial thickening of the systemic vascular bed and significant biventricular hypertrophy and dysfunction secondary to unique vascular placental connections between donor and recipient twins [94,95] which resolve weeks after delivery [95,96].…”

Section: Natural History Of Cardiac Disease In the Mid And Third Trimmentioning

confidence: 69%

Fetal Echocardiography and Prenatal Cardiovascular Interventions – An Update (2012)

Hornberger

Moon‐Grady²,

Tworetzky³

2012

J Clin Exp Cardiolog

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Fetal echocardiography has evolved considerably over the past 1-2 decades into an exciting field that bridges maternal-fetal medicine with neonatology and pediatric cardiology. With significant advances in imaging technology and experience in prenatal diagnosis, details of the cardiac pathology can now be defined much as it is postnatally; however, unique aspects of the fetal circulation limit our ability to consistently define lesion severity and to predict the evolution of cardiac defects after birth. Serial assessment has provided an understanding of the antenatal natural history of fetal heart disease, which has led to improved counseling and perinatal/neonatal management strategies. More recently, this field has focused on improving our evaluation of fetal arrhythmias, exploring the pathophysiology of fetal heart failure, detecting heart defects at earlier gestational ages, identifying novel interventions to alter the development and progression of severe disease, and investigating strategies to optimize prenatal and neonatal care in an effort to improve perinatal outcome of affected pregnancies. In this paper we will review the current state of the art of fetal/perinatal cardiology and the advances that have occurred in the field largely over the past decade.

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Section: Natural History Of Cardiac Disease In the Mid And Third Trimmentioning

confidence: 69%

Fetal Echocardiography and Prenatal Cardiovascular Interventions – An Update (2012)

Hornberger

Moon‐Grady²,

Tworetzky³

2012

J Clin Exp Cardiolog

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“…Functional findings at echocardiography were significantly more frequent among the poorly-controlled diabetic pregnancies. In other reports, the malformations found in neonates, born of insulin-dependent diabetes mellitus gestations, included endocardial cushion defects, persistent truncus arteriosus and ventricular septal defects which appear to result from aberrant cardiac neural crest development (Sekhavat et al, 2010;Abu-Sulaiman & Subaih, 2004;Hornberger, 2006;Kumar et al, 2007;Russell et al, 2008). Hypertrophic cardiomyopathy was observed in 38% of neonates from insulin-dependent diabetes mellitus pregnant women, mainly hypertrophy of the interventricular septum (Abu-Sulaiman & Subaih, 2004).…”

Section: The Strategies For Prevention and Management Of The Cardiac mentioning

confidence: 91%

“…Most types of cardiac structural lesions have been associated with diabetes mellitus, ranging from small septal defects to major heart disease (Sekhavat et al, 2010;Abu-Sulaiman & Subaih, 2004). The exact teratogenic mechanism of maternal diabetes is not fully defined and is likely multifactorial (Hornberger, 2006;Kumar et al, 2007). Diabetes mellitus affects the fetal heart both structurally and functionally.…”

Section: Congenital Cardiopathies and Diabetes Mellitusmentioning

confidence: 99%

“…Diabetes mellitus affects the fetal heart both structurally and functionally. In late gestation, it causes a unique form of hypertrophic cardiomyopathy (Ren et al, 2011;Hornberger, 2006;Chaudhari et al, 2008;Russell et al, 2008), illustrated at Fig. 1.…”

Section: Congenital Cardiopathies and Diabetes Mellitusmentioning

confidence: 99%

“…Cardiomegaly is a common finding in stillborn infants of mothers with diabetes mellitus and may contribute to the risk of fetal death in these pregnancies (Russell et al, 2008). Hypertrophic cardiomyopathy observed in the infant of the diabetic mother is characterized by thickening of the interventricular septum, and to a lesser extent the ventricular free walls (Hornberger, 2006). The presence of this pathology whether is associated with fetal hyperinsulinaemia and general somatic growth in maternal diabetes (Buchanan & Kjos, 1999;Ren et al, 2011).…”

Section: Congenital Cardiopathies and Diabetes Mellitusmentioning

confidence: 99%

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Congenital Cardiopathies Screening Associated with Diabetes Mellitus Using Maternal Fructosamine Plasma Concentration

Reis¹,

Costa²

2011

Gestational Diabetes

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Infrequently studied congenital anomalies as clues to the diagnosis of maternal diabetes mellitus

Frías

et al. 2007

American J of Med Genetics Pt A

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The aim of this study was to identify congenital anomalies (CA) among infants of women with diabetes mellitus (DM) that, even though infrequent or infrequently reported, may suggest diabetic teratogenesis. Using 1976-2005 data from the Spanish Collaborative Study of Congenital Malformations (ECEMC), we compared the frequency of selected CA among 130 infants with CA born to women with pregestational DM (PGDM) and 30,009 infants with CA whose mothers had normal glucose tolerance (NGT). To identify which CA were not only significantly more frequent among infants of mothers with PGDM, but also more specific, we calculated the quotient of their frequencies (frequency ratio: FR). The same analysis was made using data from 927 infants of mothers with gestational DM (GDM). Among the studied defects, several were statistically significantly more frequent among infants of PGDM mothers than among infants of mothers with NGT, although the specificity of their association with DM varied, as indicated by the values of the FR. These included: anorectal atresia/stenosis (FR = 2.81; P = 0.03), hallucal polydactyly (FR = 3.62; P = 0.002), heterotaxy (FR = 5.70; P = 0.049), hypertrophic cardiomyopathy (HCM) (FR = 61.60; P = 0.000000), multicystic dysplastic kidneys (MDK) (FR = 5.13; P = 0.0002), and thymus aplasia/hypoplasia (FR = 29.62; P = 0.000001). The only CA significantly more frequent among infants of women with GDM were HCM (FR = 8.60; P = 0.002) and MDK (FR = 1.80; P = 0.01). Our results suggest that maternal PGDM should be suspected in children with hallucal polydactyly, anorectal atresia/stenosis, heterotaxy, or aplasia/hypoplasia of the thymus. The presence of transient HCM or MDK in a newborn suggests maternal PGDM or GDM. These observations are important in view of the increasing worldwide frequency of DM and the high proportion of individuals with DM in whom the condition remains undiagnosed. (c) 2007 Wiley-Liss, Inc.

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Maternal diabetes and the fetal heart

Cited by 92 publications

References 31 publications

Fetal Echocardiography and Prenatal Cardiovascular Interventions – An Update (2012)

Fetal Echocardiography and Prenatal Cardiovascular Interventions – An Update (2012)

Congenital Cardiopathies Screening Associated with Diabetes Mellitus Using Maternal Fructosamine Plasma Concentration

Infrequently studied congenital anomalies as clues to the diagnosis of maternal diabetes mellitus

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