Mortality among infants of diabetic mothers with hypertrophic cardiomyopathy. (12th December 2022)

• Record Type: Journal Article
• Authors: Bolin, Elijah H.; Spray, Beverly J.; Mourani, Peter M.; Porter, Craig; Collins, R. Thomas
• Is Part Of: Journal of maternal-fetal & neonatal medicine. Volume 35:Number 25(2022)
• Page Start: 9893
• Page End: 9899
• Publication Date: 2022-12-12
• Subjects: Infant of a diabetic mother -- hypertrophic cardiomyopathy -- diabetes; Obstetrics -- Periodicals; Perinatology -- Periodicals; Infants (Newborn) -- Diseases -- Periodicals; Neonatology -- Periodicals; 618.2
• DOI: 10.1080/14767058.2022.2066993
• Languages: English
• ISSNs: 1476-7058

Abstract

Abstract: Objective: To assess the association between hypertrophic cardiomyopathy (HCM) and mortality among infants of diabetic mothers (IDMs). Methods: We performed a retrospective cohort study of hospitalized IDMs admitted at ≤14-days-old in the Pediatric Health Information System (years 2004 − 2019). Multivariable logistic regression was used to evaluate the association between HCM and mortality; covariates in the model were prematurity, sex, and congenital malformations of the cardiovascular, nervous, urinary and musculoskeletal systems. Results: Among 32, 993 IDMs, there were 203 (0.6%) with HCM. Black and Hispanic children were disproportionately represented among children with HCM compared to those without HCM (23.2 vs. 14.9%, p = .001 for Black, and 30.0 vs. 22.1%, p = .007 for Hispanic). IDMs with HCM were also larger at birth (median birth weight 4120 g [interquartile range 3600-4703] vs. 3270 g [interquartile range 2535–3910]; p < .001). In-hospital mortality in patients with HCM was greater than in those without HCM (4.9 vs. 1.3%, p < 0.001), and odds of mortality were greater among those with HCM (adjusted odds ratio 2.10, 95% confidence interval: 1.04−4.25; p = .038). Conclusion: We identify HCM as a contributor to in-hospital mortality. These data reinforce the need for more specific diagnostic criteria, better prevention of maternal diabetes, and effective therapies for HCM in IDMs.