title: Infants of diabetic mothers: echocardiographic measurements and cord blood IGF-I and IGFBP-1.
abstract: BACKGROUND
  Cardiac malformations in infants of diabetic mothers (IDMs) are five times higher than in normal pregnancies. Insulin-like growth factor-I (IGF-I) is the most important growth factor in utero and is predominantly bound by IGF binding protein-1 (IGFBP-1).
  
  
  OBJECTIVE
  To examine the echocardiographic findings of neonates of diabetic mothers and the relationship with cord blood IGF-I and IGBP-1.
  
  
  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 (HbA1c ≥ 7) 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.
  
  
  CONCLUSIONS
  The opposing relationships between cord blood IGF-I and IGFBP-1 on the cardiac morphological measurements supporting their putative opposing roles in HCM seen in IDMs. Birth weight is the best predictor of hypertrophied IVS especially in infants born to suboptimally controlled diabetic mothers.
authors.affiliation: Pediatrics Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
authors.forename: Mona M
authors.initials: MM
authors.lastname: El-Ganzoury
authors.forename: Sahar A
authors.initials: SA
authors.lastname: El-Masry
authors.forename: Rania A
authors.initials: RA
authors.lastname: El-Farrash
authors.forename: Mona
authors.initials: M
authors.lastname: Anwar
authors.forename: Rasha Z
authors.initials: RZ
authors.lastname: Abd Ellatife
mesh_terms: D001724:Birth Weight; D002312:Cardiomyopathy, Hypertrophic / Q000000981:diagnostic imaging* / Q000503:physiopathology; D003430:Cross-Sectional Studies; D004452:Echocardiography; D005260:Female; D005312:Fetal Blood / Q000737:chemistry; D005865:Gestational Age; D006442:Glycated Hemoglobin / Q000032:analysis; D006345:Heart Septal Defects, Ventricular / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006801:Humans; D007231:Infant, Newborn; D018970:Insulin-Like Growth Factor Binding Protein 1 / Q000097:blood*; D007334:Insulin-Like Growth Factor I / Q000032:analysis* / Q000378:metabolism; D007363:Intensive Care Units, Neonatal; D008297:Male; D011247:Pregnancy; D011254:Pregnancy in Diabetics / Q000097:blood*; D011446:Prospective Studies
chemical_list: D006442:Glycated Hemoglobin; D018970:Insulin-Like Growth Factor Binding Protein 1; D007334:Insulin-Like Growth Factor I; C032231:IGFBP1 protein, human; C517652:hemoglobin A1c protein, human