Diyabetik Anne Bebeğinde Görülen Kardiyovasküler Komplikasyonlar

Diyabetes mellitus, gebelik boyunca fetal gelişim üzerine olumsuz etkileri olan, yenidoğanlarda metabolik bozukluklara ve doğumsal anomalilere yol açan bir durumdur. En sık doğumsal anomaliler, kardiyovasküler, gastrointestinal, genitoüriner sistemde ve santral sinir sisteminde görülür. Oluşabilen kardiyovasküler anomaliler arasında ventriküler ve atriyal septal defekt, patent duktus arteriyozus, asimetrik septal hipertrofi, büyük arter transpozisyonu, triküspit atrezisi ve aort koarktasyonu sayılabilir. Diyabetik anne bebeklerinin intrauterin dönemden itibaren doğumsal kalp hastalıkları yönünden de takip edilmesi gereklidir. Bu yazıda, diyabetik anne bebeklerinin kardiyovasküler sistem sorunlarının değerlendirilmesi ve son literatür bilgileri eşliğinde gözden geçirilmesi amaçlanmıştır

Cardiovascular Complications in Infants of Diabetic Mothers

Diabetes mellitus is a condition that has negative effects on fetal development throughout pregnancy and causes metabolic disorders and congenital abnormalities in neonates. The most frequent congenital abnormalities are seen in cardiovascular, gastrointestinal, genitourinary system and central nervous system. The cardiac abnormalities that may develop include ventricular and atrial septal defect, patent ductus arteriosus, asymmetrical septal hypertrophy, large artery transposition, tricuspid atresia and aortic contraction. The infants of diabetic mothers need to be followed up also in respect of congenital heart diseases as of the intrauterine period. In this study, we aimed to evaluate the problems of infants of diabetic mothers and to determine risk factors of mothers during pregnancy

PDF

___

1. Garner P. Type 1 diabetes mellitus and pregnancy. Lancet. 1995;346:157-61.
2. Karabayır N, Atalay C, Adal E, Önal H. Diyabetik anne çocuklarında morbidite. JOPP Dergisi. 2011;3:139-46.
3. American Diabetes Association: Gestational Diabetes Mellitus. Diab Care. 2003;26:103-5.
4. Akarsu S, Çıtak Kurt AN, Kurt A, Yılmaz E, Aygün AD. Diyabetik anne bebeğinde klinik ve laboratuvar bulguları. Fırat Tıp Dergisi. 2008;13:199-204.
5. Haşmaşanu MG, Bolboacă SD, Matyas M, Zaharie GC. Clinical and echocardiographic findings in newborns of diabetic mothers. Acta Clin Croat. 2015;54:458-66.
6. Kheir AE, Berair R, Gulfan IG, Karrar MZ, Mohammed ZA. Morbidity and mortality amongst infants of diabetic mothers admitted into Soba university hospital, Khartoum, Sudan. Sudan J Paediatr. 2012;12:49-55.
7. Allen HD, Driscoll DJ, Shaddy RE, Feltes TF. Epidemiology and prevention of congenital heart defects. In Heart Disease in Infants, Children and Adolescent 8th Edition (Ed I Botto):577-616. Philadelphia, Lippincott Williams Wilkins, 2013.
8. Demirpençe S, İnce Demirpençe B, Meşe T, Arslanoğlu S, Tavlı V, Çalkavur Ş et al. Gebelik öncesi diyabeti olan ve gebelikte diyabeti gelişen anne bebeklerinde doğum sonrası komplikasyonlar ve doğuştan kalp hastalıklarının öngördürücüleri. Turk Ped Ars. 2014;49: 299-306.
9. Lisowski LA, Verheijen PM, Copel JA, Kleinman CS, Wassink S, Visser GH et al. Congenital heart disease in pregnancies complicated by maternal diabetes mellitus. An international clinical collaboration, literature review, and meta-analysis. Herz. 2010;35:19-26.
10. Ovalı F. Diyabetik anne çocuğu. In Neonatoloji, 2. Baskı (Eds T Dağoğlu, F Ovalı:741-6. İstanbul, Nobel Tıp, 2007.
11. Saygılı Karagöl B, Karadağ N, Zenciroğlu A, Kundak AA, Okumuş N. Yenidoğan yoğun bakımında yedi yıllık diyabetik anne bebeği deneyimi. Çocuk Dergisi. 2012;12:169-76.
12. Suhonen L, Hiilesmaa V, Teramo K. Glycaemic control during early pregnancy and fetal malformations in women with type 1 diabetes mellitus. Diabetologia. 2000;43:79-82.
13. Lisowski LA, Verheijen PM, Copel JA, Kleinman CS, Wassink S, Visser GHA et al. Congenital heart disease in pregnancies complicated by maternal diabetes mellitus. Herz. 2010;35:19-26.
14. Hay WW. Care of the infant of the diabetic mother. Curr Diab Rep. 2012;12:4-15.
15. Wren C, Birrell G, Hawthorne G. Cardiovascular malformations in infants of diabetic mothers. Heart. 2003;89:1217-20.
16. Anuk İnce D, Takçı Ş, Gümüşer R. Diyabetik anne bebeklerinin yenidoğan dönemi sorunları. Çağdaş Tıp Dergisi. 2014;4:115-20.
17. Becerra JE, Khoury MJ, Cordero JF, Erickson JD. Diabetes mellitus during pregnancy and the risks for specific birth defects: a population-based case-control study. Pediatrics. 1990;85:1-9.
18. Martínez-Frías ML. Epidemiological analysis of outcomes of pregnancy in diabetic mothers: identification of the most characteristic and most frequent congenital anomalies. Am J Med Genet. 1994;51:108-13.
19. Correa A, Gilboa SM, Besser LM, Botto LD, Moore CA, Hobbs CA et al. Diabetes mellitus and birth defects. Am J Obstet Gynecol. 2008;199:237-9.
20. Elmekkawi SF, Mansour GM, Elsafty MS, Hassanin AS, Laban M, Elsayed HM. Prediction of fetal hypertrophic cardiomyopathy in diabetic pregnancies compared with postnatal outcome. Clin Med Insights Womens Health. 2015;8:39-43.
21. Meyer-Wittkopf M, Simpson JM, Sharland GK. Incidence of congenital heart defects in fetuses of diabetic mothers: a retrospective study of 326 cases. Ultrasound Obstet Gynecol. 1996;8:8-10.
22. Gladman G, McCrindle BW, Boutin C, Smallhorn JF. Fetal echocardiographic screening of diabetic pregnancies for congenital heart disease. Am J Perinatol. 1997;14:59-62.
23. Türkmen M, Aydoğdu SA, Uygur Ö, Odabaşı AR, Yüksel H, Tosun FA. Diyabetik anne bebeklerinin yenidoğan dönem sorunları. Turkiye Klinikleri J Pediatr. 2008;17:8-14.
24. Abu-Sulaiman RM, Subaih B. Congenital heart disease in infants of diabetic mothers: echocardiographic study. Pediatr Cardiol. 2004;25:137-40.
25. Park MK. Primary myocardial disease. In Park’s Pediatric Cardiology for Practitioners Sixth Edition (Ed MK Park):321-41, Philadelphia, Elsevier Saunders, 2014.
26. Park MK. Left to right shunt lesions. In Park’s Pediatric Cardiology for Practitioners. Sixth Edition (Ed MK Park):153-83, Philadelphia, Elsevier Saunders, 2014.
27. Aman J, Hansson U, Ostlund I, Wall K, Persson B. Increased fat mass and cardiac septal hypertrophy in newborn infants of mothers with well-controlled diabetes during pregnancy. Neonatology. 2011;100:147-54.
28. Çimen D, Karaaslan S. Diyabetik anne bebeklerinde kalp işlevlerinin doku Doppler ekokardiyografi ile değerlendirilmesi. Turk Ped Ars. 2014;49:25-9.
29. Sardesai MG, Gray AA, McGrath MM, Ford SE. Fatal hypertrophic cardiomyopathy in the fetus of a woman with diabetes. Obstet Gynecol. 2001;98:925-7.
30. Roller MD, Kaplan S: Hypertrophic cardiomyopathy in in fants of diabetic mothers, an update. Am J Perinatol. 1988;5:353-8.
31. Ullmo S, Vial Y, Di Bernardo S, Roth-Kleiner M, Mivelaz Y, Sekarski N et al. Pathologic ventricular hypertrophy in the offspring of diabetic mothers: a retrospective study. Eur Heart J. 2007;28:1319-25.
32. Breitweser JA, Meyer RA, Sperling MA, Tsang RC, Kaplan S. Cardiac septal hypertrophy in hyperinsulinemic infants. J Pediatr. 1980;96:535-9.
33. Pike JI, Krishnan A, Kaltman J, Donofrio MT. Fetal and neonatal atrial arrhythmias: an association with maternal diabetes and neonatal macrosomia. Prenat Diagn. 2013;33:1152-7.
34. Arslan D, Guvenc O, Cimen D, Ulu H, Oran B. Prolonged QT dispersion in the infants of diabetic mothers. Pediatr Cardiol. 2014;35:1052-6.
35. Russell NE, Higgins MF,Kinsley BF, Foley ME, McAuliffe FM. Heart rate variability in neonates of type 1 diabetic pregnancy. Early Hum Dev. 2016;92:51-5.
36. Goldberg JF, Mery CM, Griffiths PS, Parekh DR, Welty SE, Bronicki RA et al. Extracorporeal membrane oxygenation support in severe hypertrophic obstructive cardiomyopathy associated with persistent pulmonary hypertension in an infant of a diabetic mother. Circulation. 2014;130:1923-5.

ISSN: 1300-3755
Yayın Aralığı: Yılda 4 Sayı
Başlangıç: 1992
Yayıncı: Çukurova Üniversitesi Tıp Fakültesi

Arşiv