Prevalence and pattern of congenital heart defects in infants of diabetic mothers, an experience from central India: a cross-sectional observational study

Rajkumar M. Meshram; Dhanashri Kalsarpe

doi:10.18203/2349-3291.ijcp20263811

Authors

Rajkumar M. Meshram Department of Pediatrics, Government Medical College, Nagpur, Maharashtra, India
Dhanashri Kalsarpe Department of Pediatrics, Government Medical College, Nagpur, Maharashtra, India

DOI:

https://doi.org/10.18203/2349-3291.ijcp20263811

Keywords:

Congenital heart defects, Infants of diabetic mothers, Pregestational diabetes, Gestational diabetes, Heart diseases

Abstract

Background: Genetic factors account for 10% cases of congenital heart defects (CHD), while maternal pre-gestational diabetes mellitus (PGDM) and gestational diabetes mellitus (GDM) are notable risk factors. Objective was to estimate the prevalence and pattern of CHD among infants of diabetic mothers (IDMs).

Methods: This one-year cross-sectional observational study was conducted at a tertiary care teaching institute in Central India. Maternal diabetic status was defined using American Diabetes Association guidelines. One hundred neonates born to mothers with PGDM or GDM were selected via simple random sampling. Exclusion criteria comprised a family history of CHD, exposure to cardiac teratogens, and neonates with known genetic syndromes. Demographic, maternal, and neonatal data were collected. Two-dimensional echocardiography was performed by a cardiologist following American Society of Echocardiography guidelines. Categorical and continuous variables were analyzed using Chi-square, Fisher's exact, and unpaired t tests, with significance set at p<0.05.

Results: Of the 100 neonates, 78% were born to mothers with GDM and 22% to mothers with PGDM. The overall prevalence of CHD was 30%. Acyanotic CHD constituted 96.67% of cases, while cyanotic CHD accounted for 3.33%. Patent ductus arteriosus (PDA) was the most common defect (44.33%), followed by ventricular septal defect (23.3%), atrial septal defect (20%), and a concurrent PDA-ASD combination (10%). A single case of transposition of the great arteries was observed. The CHD prevalence difference between the PGDM (36.36%) and GDM (28.21%) groups was not statistically significant.

Conclusions: The prevalence of CHD among IDMs was 30%, with acyanotic defects, particularly PDA, being the most frequent presentation. Universal fetal and neonatal echocardiography should be routinely performed in these vulnerable infants to mitigate morbidity and mortality.

References

Diabetes: World Health Organization (WHO). Available on: https://www.who.int/news-room/fact-sheets/detail/diabetes. Access on 29 June 2026

Antar SA, Ashour NA, Sharaky M, Khattab M, Ashour NA, Zaid RT, et al. Diabetes mellitus: classification, mediators and classification: a gate to identify potential targets for the development of new effective treatments. Biomed Pharmacot. 2023;168:115734.

NCD Risk Factor Collaboration (NCD-RisC). Worldwide trends in diabetes prevalence and treatment from 1990 to 2022: a pooled analysis of 1108 population representative studies with 141 million participants. Lancet. 2024;404(10467):2077-93.

Sekher TV, Flood D, Green H, Hu P, Ali MK, Shete A, et al. Prevalence, awareness, treatment, and control of diabetes in India: a nationally representative survey of adults aged 45 years and older. Lancet Glob Health. 2025;13(9):e1543-52.

Mantri N, Goel AD, Patel M, Baskarn P, Dutta G, Kumar M, et al. National and regional prevalence of gestational diabetes mellitus in India: a systematic review and Meta-analysis. BMC Public Health. 2024;24(1):527.

Al-Biltagi M, El razaky O, El Amrousy D. Cardiac changes in infants of diabetic mothers. World J. Diabetes 2021;12(8):1233-47.

Ibrahim S, Gaborit B, Lenoir M, Collod-Beroud G, Stefanovic S. Maternal pre-existing diabetes: a non-inherited risk factor for congenital cardiopathies. Int J Mol Sci. 2023;24(22):16258.

Papazoglou AS, Moysidis DV, Panagopoulos P, Kaklamanos EG, Tsagkaris C, Vouloagkas I, et al. "Maternal diabetes mellitus and its impact on the risk of delivering a child with congenital heart disease: a systematic review and meta-analysis". J Matern Fetal Neonatal Med. 2022;35(25):7685-94.

Gonuguntla K, Abugrin M, Thyagaturu H, Younas HMW, Valand H, Upreti P, et al. Impact of Maternal Diabetes on the Incidence of Critical Congenital Heart Disease in the United States. JACC Adv. 2025;4(10 Pt 2):102176.

Turunen R, Pulakka A, Metsälä J, Vahlberg T, Ojala T, Gissler M, et al. Maternal Diabetes and Overweight and Congenital Heart Defects in Offspring. JAMA Netw Open. 2024;7(1):e2350579.

Afridi SB, Khan M, Shaikh M, Shaikh AS. Frequency and pattern of congenital heart defect in infant of diabetic mother at tertiary care hospital. Liaquat National J Prim Care. 2023;5:82-6.

Dominic B, Mithun HK. Spectrum of congenital heart diseases in infants of diabetic mothers. Karnataka Paediatr J. 2025;40:19-22.

Arul AS, Babu Kandha Kumar AS, Kiruthiga K, Priya MK, Neveythaa SA. Spectrum of cardiovascular abnormalities in infants born to diabetic mother in a tertiary care center. Ind J Car Dis Wom. 2019;4:124-8.

Roodpeyma S, Rafieyian S, Khosravi N, Hashemi A. Cardiovascular complications in infants of diabetic mothers: an observational study in a pediatric cardiology clinic in Tehran. J. Compr Ped. 2013;4:119-23.

Tabib A, Shirzad N, Sheikhbahaei S, Mohammadi S, Qorbani M, Haghpanah V, et al. Cardiac malformations in fetuses of gestational and pre gestational diabetic mothers. Iran J Pediatr. 2013;23:664-68.

American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care. 2010;33(1):S62-9.

Ballard JL, Khoury JC, Wedig K, Wang L, Eilers-Walsman BL, Lipp R. New Ballard Score, expanded to include extremely premature infants. J Pediatr. 1991;119(3):417-23.

Lang RM, Badano LP, Mor-Avi V. Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr. 2015;28(1):1-39.e14.

Xu J, Li Q, Deng L, Xiong J, Cheng Z, Ye C. Global, regional, and national epidemiology of congenital heart disease in children from 1990 to 2021. Front Cardiovasc Med. 2025;12:1522644.

Saxena A. Congenital heart disease in India: a status report. Indian Pediatr. 2018;55:1075-82.

Randad K, Das P, Sarkate AD, Ansari Q. Incidence and clinical profile of cardiovascular abnormalities in infants of diabetic mother. Digital J Clin Med. 2025;7(3):4.

Shamaoon M, Zunaira, Ahsan M, Maqbool T, Aslam R, Yaseen A. Congenital heart defects in infants born to diabetic mother (IDM): a single center experience. Professional Med J. 2020;27:950-6.

Arjmandnia MH, Yousefi M, Rezvan S, Vahedian M, Noor E, Mohammadi A, et al. Evaluation of congenital heart diseases in neonates with diabetic mothers who reffered to teaching hospital in Qom, Iran. J Vessel Circ. 2020;1:33-6.

Al Ghadeer HA, Alherz AH, Albattat FS, Alkhamis MA, Alamer MH, Almulaifi LF, et al. Pattern and Frequency of Congenital Heart Defects Among Infants of Diabetic Mothers. Cureus. 2024;16:e76184.

Delgado Y, Gaytan C, Perez N, Miranda E, Morales BC, Santos M. Association of congenital heart defects (CHD) with factors related to maternal health and pregnancy in newborns in Puerto Rico. Congenit Heart Dis. 2024;19:19-31.

Øyen N, Diaz LJ, Leirgul E, Boyd HA, Priest J, Mathiesen ER, et al. Prepregnancy Diabetes and Offspring Risk of Congenital Heart Disease: A Nationwide Cohort Study. Circulation. 2016;133:2243-53.

Nagasawa M, Ikehara S, Aochi Y, Tanigawa K, Kitamura T, Sobue T, et al. Maternal diabetes and risk of offspring congenital heart diseases: the Japan Enviornment and Children study. Enviornmental Health Prevent Med. 2024;29:23.

Mohammed AA, Walid AWE, Renad MA, Reema MA, Abdulaziz MA. Prevalence of congenital heart defects in infants of diabetic mothers in Aseer region, Southwestern, Saudi Arabia. Int J Pediatr Neonatol. 2023;5(1):10-4.

Alyousif SMM, Aldokhel FT, Alkhanbashi OK, Alqahtani MHA, Aladawi AMM, Ashmawi AA, et al. The Incidence of Congenital Heart Defects in Offspring Among Women with Diabetes in Saudi Arabia. Cureus. 2021;13:e14225.

Begum S, Dey SK. Clinical profile and pattern of congenital heart disease in infants of diabetic mother and infants of non-diabetic mother at a tertiary care hospital. J Neonatal Perinatal Med. 2017;10:403-8.