Incidence and Clinical Profile of Cardiovascular Abnormalities in Infants of Diabetic Mother

Background: Maternal diabetes is associated with adverse pregnancy outcomes, notably congenital heart disease (CHD) in infants of diabetic mothers (IDMs). This study evaluated the prevalence and spectrum of CHDs in IDMs and the effect of maternal glycemic control. Materials and Methods: A prospective observational study was conducted over 18 months at a tertiary care centre in Mumbai. A total of 112 IDMs were enrolled. Maternal glycemic status was assessed using HbA1c and random blood sugar. All infants underwent clinical examination, oxygen saturation measurement, and echocardiography. Results: CHDs were identified in 26.7% of infants. The most frequent lesions were ventricular septal defect (12.5%), hypertrophic obstructive cardiomyopathy (3.6%), atrial septal defect (3.6%), patent ductus arteriosus (2.6%), tetralogy of Fallot (1.8%), transposition of great arteries (1.8%), and truncus arteriosus (0.9%). Infants of mothers with overt diabetes had a higher incidence of CHD (47.2%) than those with gestational diabetes (17.3%). Poor glycemic control (HbA1c >6.4) was strongly associated with CHD, particularly cyanotic lesions. CHD prevalence was highest in infants of mothers requiring both insulin and metformin (37.5%). Conclusion: Poor maternal glycemic control significantly increases CHD risk in IDMs. Strict glucose management during pregnancy and routine antenatal echocardiography are essential for early detection and improved outcomes.