Incidence of Hypertrophic Cardiomyopathy in Infants of Diabetic Mothers Attending in NICU at Assiut University Children Hospital During One Year
Condition: Hypertrophic Cardiomyopathy
MeSH terms: Cardiomyopathies; Cardiomyopathy, Hypertrophic; Hypertrophy
Study type: Interventional

Summary: 
      To evaluate all full term infants of diabetic mother for the presence of hypertrophic
      cardiomyopathy who admitted in NICU at Assiut University Children Hospital and to follow up
      of these cases after 6 months for recovery.
    

Detailed description: 
      Diabetes is the most common endocrine disorder complicating pregnancy. Incidence of both
      type-I and type-II diabetes is increasing, throughout the world. As the incidence of diabetes
      continues to rise and increasingly affects individuals of all ages including young adults and
      children, women in child bearing age are at increased risk of diabetes during pregnancy [1].

      The type 1 diabetes around the time of conception produces marked risk of embryopathy (neural
      tube defects, cardiac defects, and caudal regression syndrome) as these mother have high
      glycosylated hemoglobin at the time of embryogenesis (around 6-8 weeks of gestation) rather
      than IDM that are born to type 2 diabetes mothers who have macrosomia and other milder
      problems. The mothers who have been diagnosed as severe and unstable type1 diabetes in the
      later part of gestation have high chances of neonate being more affected with intrauterine
      growth restriction, asphyxia, and fetal death [2] and [3].

      Due to the teratogenic effect of maternal diabetes, the reported incidence of congenital
      malformations among the newborns of diabetic mothers is five times greater than that of the
      general population [4].

      Cardiac malformations are one of the most common types of these malformations which occur in
      about 8.5% of cases that is about 10 times more than its incidence in normal population
      (0.8%) [5].

      Fetuses exposed to maternal hyperglycemia and hyperinsulinism, are prone to develop
      hypertrophic cardiomyopathy. It primarily affects the inter-ventricular septum, but can
      extend to the myocardium in more severe cases. Although the perinatal mortality rates
      associated with diabetes in pregnancy have declined considerably during the past eight
      decades and are now near those in the general population, it is only through continuing
      vigilance that such advances can be maintained. Both fetal and neonatal deaths occurred with
      increased frequency in diabetic pregnancies before the advent of modern management methods,
      and fetal deaths nationwide continue to be significantly higher among diabetic than
      non-diabetic pregnancies [6].

      The most recent available data indicate that the relative risk of stillbirth in pregnancies
      complicated by type 1 diabetes (compared to the general population) is 2.9-4.3 folds, and for
      type 2 diabetes 2.5-4.5 fold [7].
    

Intervention name(s): echocardiography
Intervention type(s): Diagnostic Test
Intervention description(s): evaluation idm for cardiomyopathy by echo
Intervention model: Sequential Assignment
Intervention model description: To evaluate all full term infants of diabetic mother for the presence of hypertrophic cardiomyopathy who admitted in NICU at Assiut University Children Hospital and to follow up of these cases after 6 months for recovery.
Masking: None (Open Label)
Primary purpose: Diagnostic