Frequency and Patterns of Congenital Heart Defects in Neonates of Diabetic Mothers at a Tertiary Care Hospital

Objective: To assess the incidence and spectrum of Congenital Heart Defects (CHDs) in neonates born to mothers with Gestational Diabetes Mellitus (GDM), compared to those born to non-diabetic mothers. Methodology: This retrospective comparative study was conducted at the Department of Pediatric Cardiology, Bahawal Victoria Hospital, Bahawalpur, over one year from September 2023 to September 2024. A total of 260 neonates were included and divided into two groups: 130 born to mothers with GDM and 130 to non-diabetic mothers. Inclusion required complete maternal antenatal and neonatal records. Neonates with syndromic features or known chromosomal anomalies were excluded. Maternal glycemic status was verified from antenatal clinic files, and CHD diagnosis was based on echocardiography performed within the first week of life. The frequency and types of CHDs were recorded and compared. Data were analyzed using SPSS version 26.0, with p < 0.05 considered statistically significant. Results: CHDs were significantly more common among neonates of diabetic mothers (15.4%) compared to non-diabetic mothers (4.6%) (p < 0.01). Patent foramen ovale (PFO) and atrial septal defect (ASD) were significantly higher in the diabetic group—10% vs. 3.1% and 11.5% vs. 3.8%, respectively. Although not statistically significant, increased frequencies of ventricular septal defect (VSD), patent ductus arteriosus (PDA), dextro-transposition of the great arteries (dTGA), and tetralogy of Fallot (TOF) were also noted in neonates of diabetic mothers. Conclusion:Neonates born to mothers with GDM are at a significantly higher risk of developing congenital heart defects, emphasizing the need for early fetal cardiac evaluation and targeted postnatal screening in this high-risk group.