The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians · 2022
Mortality among infants of diabetic mothers with hypertrophic cardiomyopathy.
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Bolin Elijah H, Spray Beverly J, Mourani Peter M, Porter Craig, Collins R Thomas
Аннотация
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.
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.