Bolin Elijah H, Spray Beverly J, Mourani Peter M, Porter Craig, Collins R Thomas
Department of Pediatrics, Section of Cardiology, University of Arkansas for Medical Sciences and Arkansas Children's Research Institute, Little Rock, AR, USA.
Department of Biostatistics, Arkansas Children's Research Institute, Little Rock, AR, USA.
J Matern Fetal Neonatal Med. 2022 Dec;35(25):9893-9899. doi: 10.1080/14767058.2022.2066993. Epub 2022 Apr 19.
To assess the association between hypertrophic cardiomyopathy (HCM) and mortality among infants of diabetic mothers (IDMs).
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.
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%, = .001 for Black, and 30.0 vs. 22.1%, = .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]; .001). In-hospital mortality in patients with HCM was greater than in those without HCM (4.9 vs. 1.3%, < 0.001), and odds of mortality were greater among those with HCM (adjusted odds ratio 2.10, 95% confidence interval: 1.04-4.25; = .038).
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.
评估肥厚型心肌病（HCM）与糖尿病母亲所生婴儿（IDM）死亡率之间的关联。
我们对2004年至2019年期间在儿科健康信息系统中入院时年龄≤14天的住院IDM进行了一项回顾性队列研究。采用多变量逻辑回归来评估HCM与死亡率之间的关联；模型中的协变量包括早产、性别以及心血管、神经、泌尿和肌肉骨骼系统的先天性畸形。
在32993名IDM中，有203名（0.6%）患有HCM。与未患HCM的儿童相比，患HCM的儿童中黑人及西班牙裔儿童的比例过高（黑人：23.2%对14.9%，P = 0.001；西班牙裔：30.0%对22.1%，P = 0.007）。患HCM的IDM出生时体重也更大（出生体重中位数4120克[四分位间距3600 - 4703]对3270克[四分位间距2535 - 3910]；P < 0.001）。患HCM的患者院内死亡率高于未患HCM的患者（4.9%对1.3%，P < 0.001），且患HCM的患者死亡几率更高（调整后的优势比为2.10，95%置信区间：1.04 - 4.25；P = 0.038）。
我们确定HCM是导致院内死亡的一个因素。这些数据强化了对更具体诊断标准、更好地预防母亲糖尿病以及对IDM中HCM进行有效治疗的需求。
