妊娠与儿童健康杂志

抽象的

Maternal Gestational Diabetes and Fetal Congenital Heart Disease: An Observational Study

Lindsey E Hunter and Gurleen K Sharland

Background: Maternal type 1 diabetes mellitus (DM) is a recognised risk factor for the development of fetal congenital heart disease (CHD). However the risk of CHD in babies of women with gestational diabetes mellitus (GDM) is less well known.

Objectives: The aim of this 10 year, retrospective, observational study was to compare the occurrence of congenital heart disease in these two referral groups and to evaluate whether detailed fetal echocardiography should be offered to women with GDM.

Results: During the study period 1401 women with type 1 DM were referred for fetal echocardiography and a fetal congenital heart defect was diagnosed in 44 cases (3.1%). In the GDM cohort 543 women were referred for screening and 15 cases (2.76%) of fetal CHD were detected.

Conclusions: Based on our data we consider women with GDM to be at an increased risk of having a baby with CHD. This risk might be due to a combination of hyperglycaemia, insulin resistance, an elevated BMI and more importantly, undiagnosed pre-gestational diabetes. Until more detailed data from larger studies is available, we will continue to accept these women as referrals for detailed fetal echocardiography.