الفهرس 
Diabetes and PregnancyOnly 14 pages are availabe for public view
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Abstract
Over the last decade; there was a great deal of interest about whether the lipid changes observed during the fetal period could result in permanent changes in the structure and functions of the organs that would be reflected in adult life.
Some experimental and clinical studies have shown the presence of fatty striae in the aorta during fetal developmental period, while other epidemiological investigations tried to link weight and lipid changes at birth to coronary heart diseases in adult life; however; the results remain inconclusive.
The aim of the current study was to evaluate the effect of maternal diabetic and hyperlipidemic status on the infant’s cardiac condition and assess the risk of being an atherosclerotic risk factor.
This study was conducted on 60 neonates (Group I: 20 macrosomic IDMs, Group II: 20 non macrosomic IDMs, Group III: 20 healthy neonates of healthy mothers).
All neonates included in this study were subjected to:
full history taking from their mothers laying stress on perinatal history including: Type of maternal diabetes and its duration, Insulin dose, regimen, the degree of compliance to treatment, glycemic control, diabetic complications, family history and previous siblings with CVD.
Clinical Examination was stressed on: gestational age, sex, birth weight, length, body surface area, Ponderal Index, blood pressure, heart rate and full cardiac examination.
HbA1c of mothers was measured with HPLC (high performance liquid chromatography) using Bio-rad, Dimensions, Siemens, USA.
Maternal and neonatal Serum HDL, LDL, TG and cholesterol using Synchron CX9 autoanalyzer and were calculated by Friedrickson-Friedwald’s formula.
Patients with congenital and cardiac abnormalities were excluded from the study.
2D M Mode, continuous wave, pulsed wave, colored Doppler echocardiography were done for detection of any congenital abnormality, assessment of left ventricular end diastolic and end systolic dimensions, Interventricular septal thickness and posterior wall thickness as well as left ventricular mass that was indexed to BSA.
Abdominal intima media thickness was assessed by examining the distal 15 mm of the abdominal aorta at the end-diastole using a 7.5-MHz pediatric phased-array transducer.
Left ventricular mass thickness was assessed by using the MSA formula
LVMI = 0.8{1.04[([LVEDD + IVSd +PWd]3 − LVEDD3)]} + 0.6𝐵𝑆𝐴 (Lang et al., 2005)
Our results demonstrate that macrosomia and hypertrophic cardiomyopathy in IDMs are associated findings. The results of the current study revealed that:
• Maternal HbA1c mean values were the highest among diabetic mothers of macrosomic infants and the lowest in mothers of the control infants group linking the relation between maternal glycemic control with the risk of complications
• Mean values of maternal serum TG level were significantly higher in diabetic mothers of macrosomic infants when compared to diabetic mothers of non macrosomic infants.
• No significant difference was found when comparing the macrosomic IDMs, non macrosomic IDMs and control groups as regards the mean values of maternal serum HDL, LDL and cholesterol.
• Mean values of neonatal serum cholesterol, HDL and LDL mean values were significantly the highest in the non macrosomic IDMs and the lowest in the control group.
• aIMT was significantly the highest among the macrosomic IDMs group and the lowest among the control infants group.
• LVMI was significantly the highest among the macrosomic IDMs group and the lowest among the control infants group.
• A significant positive correlation was found between aIMT and the mean values of maternal serum HbA1c, TG and cholesterol as well as the mean values of neonatal serum TG and cholesterol in macrosomic IDMs.
• A significant positive correlation was found between aIMT and the mean values of maternal serum HbA1c, HDL levels while it was found to be in a significant negative correlation with mean values of neonatal serum cholesterol, HDL and LDL levels in all IDMs.
• A significant positive correlation was found between LVMI and mean values of maternal serum TG levels in the macrosomic IDMs group.
• A significant negative correlation was found between LVMI and the mean values of neonatal serum cholesterol, HDL and LDL in all IDMs.
• A significant positive correlation was found between aIMT and LVMI in non macrosomic IDMs group while it was found to be a negative correlation in the macrosomic IDMs and control infants groups.