Prevalence and pattern of congenital heart defects in infants of diabetic mothers, an experience from central India: a cross-sectional observational study

Background: Genetic factors account for 10% cases of congenital heart defects (CHD), while maternal pre-gestational diabetes mellitus (PGDM) and gestational diabetes mellitus (GDM) are notable risk factors. Objective was to estimate the prevalence and pattern of CHD among infants of diabetic mothers (IDMs). Methods: This one-year cross-sectional observational study was conducted at a tertiary care teaching institute in Central India. Maternal diabetic status was defined using American Diabetes Association guidelines. One hundred neonates born to mothers with PGDM or GDM were selected via simple random sampling. Exclusion criteria comprised a family history of CHD, exposure to cardiac teratogens, and neonates with known genetic syndromes. Demographic, maternal, and neonatal data were collected. Two-dimensional echocardiography was performed by a cardiologist following American Society of Echocardiography guidelines. Categorical and continuous variables were analyzed using Chi-square, Fisher's exact, and unpaired t tests, with significance set at p<0.05. Results: Of the 100 neonates, 78% were born to mothers with GDM and 22% to mothers with PGDM. The overall prevalence of CHD was 30%. Acyanotic CHD constituted 96.67% of cases, while cyanotic CHD accounted for 3.33%. Patent ductus arteriosus (PDA) was the most common defect (44.33%), followed by ventricular septal defect (23.3%), atrial septal defect (20%), and a concurrent PDA-ASD combination (10%). A single case of transposition of the great arteries was observed. The CHD prevalence difference between the PGDM (36.36%) and GDM (28.21%) groups was not statistically significant. Conclusions: The prevalence of CHD among IDMs was 30%, with acyanotic defects, particularly PDA, being the most frequent presentation. Universal fetal and neonatal echocardiography should be routinely performed in these vulnerable infants to mitigate morbidity and mortality.