[Natural history of myocardial hypertrophy and its association with hyperinsulinism in infants of diabetic mothers].

PURPOSE

To test the hypothesis that myocardial hypertrophy is associated with increased serum insulin levels in children of diabetic mothers and to determine the frequency and timing of this spontaneous regression.

METHODS

Seventy-two patients were studied (54 children of diabetic mothers and 18 controls). Diagnosis of myocardial hypertrophy was made by fetal echocardiography. Amniotic fluid insulin levels were obtained from a previous prenatal study on hypertrophic cardiomyopathy, since the participation of the mothers was common to both projects.

RESULTS

There were 10 cases of myocardial hypertrophy among children of diabetic mothers (18.52%). Septal thickness was significantly different between the 2 groups (children of diabetic mothers and controls) in the evaluation performed at the age of 1 month (p = 0.04). Insulin levels were still increased in children of diabetic mothers until the age of 3 months. During this period insulin levels were significantly higher than those of controls (p = 0.003 and p = 0.001, at 1 and 3 months, respectively). The association between regression of ventricular septum thickness and the decrease of insulin levels occurred up to the age of 1 month.

CONCLUSION

There was spontaneous regression of ventricular septum thickness in children of diabetic mothers during the first 6 months of life. The association between hyperinsulinism and hypertrophic cardiomyopathy was present up to the first month of life.