Infants of diabetic mothers: echocardiographic measurements and cord blood IGF-I and IGFBP-1

El–Ganzoury MM et al. – The opposing relationships between cord blood Insulin–like growth factor–I (IGF–I) and IGFBP–1 on the cardiac morphological measurements supporting their putative opposing roles in HCM seen in infants of diabetic mothers (IDMs). Birth weight is the best predictor of hypertrophied IVS especially in infants born to suboptimally controlled diabetic mothers.

Methods

• This study was conducted on 69 neonates born to diabetic mothers who were admitted to the neonatal intensive care unit, Ain Shams University Hospitals between August 2007 and February 2008.
• They were classified into three groups: 20 small for gestational age, 25 appropriate for gestational age, and 24 large for gestational age.
• Neonates were subjected to thorough clinical examination and echocardiographic evaluation.
• Maternal hemoglobin A1c (HbA1c) and cord blood IGF-I and IGBP-1 were assessed.

Results

• Thirty neonates (43.5%) had hypertrophic cardiomyopathy (HCM); all of them were infants of suboptimally controlled diabetic mothers with positive correlation between HbA1c and interventricular septal (IVS) thickness.
• Impaired left ventricular contractility was recorded in 52 IDMs (75.4%).
• The echocardiographic and laboratory measurements showed significant difference between the three studied groups.
• Cardiac morphological data were negatively correlated to IGFBP-1 and positively correlated to IGF-I and birth weight.

[more...]