Ali Rıza FİRUZAN, Banu DEMİRPENÇE İNCE, Şebnem ÇALKAVUR, Timur MEŞE, Vedide TAVLI, Sertaç ARSLANOĞLU, Özgür OLUKMAN, Savaş DEMİRPENÇE

Gebelik öncesi diyabeti olan ve gebelikte diyabeti gelişen anne bebeklerinde doğum sonrası komplikasyonlar ve doğuştan kalp hastalıklarının öngördürücüleri

Amaç: Bu çalışmada, gebelik öncesi diyabeti olan ve gebelikte diyabeti gelişen anne bebeklerinin doğum sonrası döneme ait sorunlarını ve doğumsal kalp hastalığı saptanan bebekle- rin klinik özelliklerini değerlendirmeyi amaçladık. Gereç ve Yöntemler: Yenidoğan Birimimizde Ocak 2010- Ocak 2012 tarihleri arasında diyabetik anne bebeği tanısıyla izlenen 337 yenidoğanın kayıtları geriye dönük olarak in- celendi. Diyabetik anne ve bebeğine ait demografik veriler, doğum sonrası dönemdeki diyabetik anne bebeği sorunları ve transtorasik ekokardiyografi ile saptanan doğuştan kalp hastalıkları incelendi. Bulgular: Olgular diyabetin tipine göre The American Cong- ress of Obstetricians and Gynecologists (ACOG) önerileri doğrultusunda grup A, B ve C şeklinde gruplara ayrıldı. En sık doğum sonrası sorunlar; hiperbilirübinemi, solunum sı- kıntısı, hipoglisemi ve hipokalsemi idi. Grup Ada %17,3, grup Bde %50 ve grup Cde %9 doğuştan kalp hastalığı saptandı. Cinsiyet, çoğul gebelik, diyabet tipi, diyet tedavisi, ağızdan antidiyabetik alımı ve ilaç kullanımı ile doğuştan kalp has- talığı görülmesi arasında ilişki saptanmadı. Genetik hastalık, üfürüm, siyanoz ve gebelikte hipertansiyon varlığı ile doğuş- tan kalp hastalığı görülmesi arasında pozitif yönde anlamlı ilişki saptandı. İnsülin kullanımı, genetik hastalık ve gebelikte hipertansiyon varlığının doğuştan kalp hastalığı riskini artır- dığı gösterildi. Çıkarımlar: Çalışmamızda diyabetik anne bebeklerinde do- ğuştan kalp hastalığı genel sıklığı %24 bulunmuştur. Gebelik öncesi ve gebelikte diyabeti gelişen anne bebeklerinin do- ğuştan kalp hastalığı riski yönünden araştırılmasının önemli olduğu hatırlanmalıdır. (Türk Ped Arş 2014; 49: 299-306)

Predictors of postnatal complications and congenital cardiac diseases in infants of mothers with pregestational and gestational diabetes

Aim: In this study, we aimed to evaluate the postnatal prob- lems of infants of mothers with pregestational and gesta- tional diabetes and the clinical properties of infants who were found to have congenital cardiac disease. Material and Methods: We retrospectively examined the records of 337 newborns who were followed up with a di- agnosis of infant of diabetic mother between January 2010 and January 2012 in our Neonatology Unit. The demographic data of the diabetic mothers and their babies, the postnatal problems of the babies of diabetic mothers and congenital heart diseases found on transthoracic echocardiography were examined. Results: The patients were classified as group A, B and C in accordance with the recommendations of The American Congress of Obstetricians and Gynecologists (ACOG) ac- cording to the type of diabetes. The most common postnatal problems included hyperbilirubinemia, respiratory distress, hypoglycemia and hypocalcemia. The rate of congenital heart disease was found be 17.3% in group A, 50% in group B and 9% in group C. No correlation was found between congenital heart disease and gender, multiple pregnancy, diabetes type, diet treatment, use of oral antidiabetic drugs and drug usage. A positive significant correlation was found between congen- tal heart disease and genetic disease, murmur, cyanosis and presence of gestational hypertension. It was shown that use of insulin, genetic disease and presence of gestational diabe- tes increased the risk of congenital heart disease. Conclusions: In our study, the overall incidence of congeni- tal heart disease was found to be 24% in infants of diabetic mothers. It should be kept in mind that it is important to nvestigate the infants of mothers with pregestational and gestational diabetes in terms of the risk of congenital heart disease. (Türk Ped Arş 2014; 49: 299-306)

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