Echocardiographic findings of congenital cardiopathies among fetuses of diabetic pregnant women and their relationship with plasma fructosamine levels.
OBJECTIVE
To study the occurrence of congenital cardiopathies at echocardiography (CCE) in fetuses whose mothers had preexisting diabetes mellitus (PGDM) and to study the potential of using fructosamine level as a late marker (beyond the first trimester) for CCE.


METHODS
A register study covering 91 pregnant women that underwent routine fetal echocardiography ordered due to PGDM. The first dosage of plasma fructosamine found in 65 medical records was analyzed during prenatal care (20.4 ± 8.0 weeks of gestation). The presence or absence of structural or functional CCE was associated with fructosamine levels by logistic regression. We assessed the effect modification odds ratio by maternal age and insulin usage.


RESULTS
Thirty-four fetuses (52.3% of 65 fetuses) presented CCE. Twenty of them had functional CCE and 14 presented structural CCE. The mean maternal plasma fructosamine level was higher among pregnant women whose fetuses presented CCE than in those whose fetuses did not (2.86 ± 0.73 mmol/l, 2.22 ± 0.54 mmol/l, respectively, p < 0.0001). Crude OR for CCE and abnormal plasma fructosamine (>2.68 mmol/l) was 9.6 (2.8-33.7, 95% CI, p < 0.0001). Adjusted OR by maternal age and insulin usage was 10.9 (2.7-45.2, 95% CI p < 0.0001).


CONCLUSIONS
An abnormal plasma fructosamine level increases the chances of CCE occurring among referral pregnant women with PGDM.
Department of Obstetrics and Gynecology, Fetal Medicine Center, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil. zilma.medicina@gmail.com
Zilma S N
ZS
Reis
Ana P B
AP
Miranda
Eura M
EM
Lage
Renan D
RD
Bragança
Carolina R
CR
Costa
Antônio C V
AC
Cabral
D000328:Adult; D015415:Biomarkers / Q000097:blood; D001938:Brazil; D004452:Echocardiography; D005260:Female; D019270:Fructosamine / Q000097:blood*; D006330:Heart Defects, Congenital / Q000097:blood* / Q000000981:diagnostic imaging / Q000209:etiology; D006801:Humans; D011247:Pregnancy; D011262:Pregnancy Trimester, Second / Q000097:blood; D011254:Pregnancy in Diabetics / Q000097:blood* / Q000000981:diagnostic imaging; D011295:Prenatal Care; D055815:Young Adult
D015415:Biomarkers; D019270:Fructosamine