Maternal diseases and their effect on the heart of the fetus

The presence of some maternal diseases during pregnancy is possible. affect the fetus. This article talks about these diseases and their effect on the heart and other organs of the fetus.

Can mother's diseases affect the child?

Diabetes, maternal obesity, maternal autoimmune disease, mother's phenylketone urea disease, family history of heart disease, are only a few of the diseases that the mother has can have a negative result in pregnancy. Early diagnosis of these diseases can greatly reduce its effects on the baby. This article talks about diseases that directly affect the heart or the fetus in general. Related information about fetal echocardiography for mothers

Maternal diseases that directly affect the heart of the fetus

### 1- Maternal autoimmune disease Arrhythmia of complete heart beat block (independent of having the upper and lower chambers of the heart beat together) occurs in approximately 4% of these pregnancies. Especially when autoimmune antibodies are detected in the mother without symptoms or with symptoms. If the mother's previous child had complete heart block, the risk of complete heart block in the next pregnancy is approximately 19%. Other cardiovascular abnormalities related to maternal antibodies are: myocarditis or inflammation of the heart muscle, cardiomyopathy or structural abnormality of the heart muscle, endocardial fibrolastosis or reduced elasticity of the inner layer of the heart muscle, ventricular arrhythmias and dysplasia (non-formation) of the atrioventricular valves or semilunar valves. ### 2- Maternal phenylketonuria disease Maternal phenylketonuria (PKU), in which the serum phenylalanine level is greater than 15 mg/dL, increases the risk of congenital heart disease in the fetus between 10 and 15 times. If the mother's phenylalanine level before pregnancy and during the first trimester of pregnancy is less than 6 mg/dL, the risks of congenital heart diseases will be lower. However, if its level is more than 10 mg/dL, a fetal echocardiogram will be required. ### 3- Family history of congenital heart disease In general, the estimate of the fetus suffering from congenital heart diseases is 7.5 times when the mother has congenital heart diseases, 2.2 times when the father has congenital heart diseases, and 2 to 6 times the presence of congenital heart diseases in previous children. Depending on the type of disease in these dependents, the probability of occurrence in this pregnancy is different. ### 4- Maternal obesity The prevalence of obesity, defined as a body mass index (BMI) greater than or equal to 30, is rapidly increasing among mothers. This weight gain poses almost negligible risk. The risk is equal to: 1.18 times for obese mothers with BMI 30 and 1.40 times for obese mothers with BMI index. If the mother is obese, most of these defects are defects of the inter-atrial or ventricular wall. Considering the low risk, it makes more sense to perform a detailed heart screening instead of a fetal echocardiogram.

Maternal diseases that generally affect the fetus.

### 1- Maternal diabetes One of the mother's diseases that requires high attention. It is diabetes. To diabetic people who are planning to get pregnant and women who have gestational diabetes. (diabetes that occurs during pregnancy) is recommended. to carefully control the conditions during pregnancy. High blood sugar, especially in the first trimester, can cause birth defects and miscarriage. Gestational diabetes that starts in late pregnancy. It is usually less risky than pre-gestational diabetes or first-trimester diabetes. It can lead to the birth of an obese baby. Babies with macrosomia may have health problems. Among these problems, we can mention the damage to their shoulders during childbirth. Due to the extra insulin produced by the baby's pancreas, these babies may have very low blood sugar levels at birth. They are also at greater risk of developing respiratory problems. These types of babies will become adults in the future. who are at risk of obesity and also at risk of type 2 diabetes (or adult-onset diabetes). Mother's diabetes and effect on fetal heart development

### 2- Toxoplasmosis Toxoplasmosis is a possible maternal disease caused by a parasite. It is present in cat feces or uncooked meats. Toxoplasmosis rarely causes more severe symptoms than the flu in adults. But the pregnant mother who was infected during pregnancy or just before pregnancy. It can transfer this infection to the fetus and endanger the health of the unborn child. These babies often have eye infections, enlarged liver and spleen, jaundice (yellowing of the skin and eyes) and pneumonia. Even some of these babies die within a few days after birth and those who survive are also possible. have mental disabilities, severe visual impairment, cerebral palsy, seizures and other serious problems. ### 3- Rubella (rubella) Measles, also known as German measles, is caused by a vaccine. In 1969, it almost disappeared in the world. However, there is still a risk of rubella during pregnancy as a maternal disease. While this disease only causes discomfort and disease in the mother for a week or more. Its impact on the newborn can be much more serious. Congenital defects caused by congenital rubella infection include eye defects such as cataracts, glaucoma and blindness, deafness, congenital heart defects and mental retardation. Collectively, these conditions are called congenital rubella syndrome (CRS). ### 4- Cytomegalovirus Cytomegalovirus (CMV) is a very common virus. which usually remains dormant in the body after being placed in the body without causing any problems. This CMV virus can cause serious problems for the health of people who have a low immune system or in the fetus. Infants infected with CMV before birth are at risk of several defects such as microcephaly (small head size), hepatomegaly (enlarged liver), jaundice (yellowing of the skin and eyes), anemia (low blood count), pneumonia, seizures, vision loss, hearing loss, and serious cases. Even children who are born without any of these defects are possible. Later, they face partial hearing loss, poor vision, some developmental problems, and learning difficulties. ### 5- streptococci type B Streptococcus type B (GBS) is a bacterial disease. which can cause infections that threaten the baby's life. Babies are at risk of mother's diseases, it is possible. Have sepsis (blood infection), pneumonia or meningitis. Strep type B can occur in pregnant women. Cause bladder infection, uterine infections (amnionitis, endometritis) and stillbirth (CDC). Type B streptococcus can be treated with antibiotics. ### 6- Thyroid One of the maternal diseases that is very common in pregnant women. Thyroid disorders, especially hypothyroidism (thyroid hormone deficiency), are related to a decrease in IQ in babies and an increase in the rate of miscarriage and birth defects if not treated. Synthetic hormone drugs are used to treat hypothyroidism. The chemical structure of these drugs is almost identical to the natural hormone. In general, their consumption is considered safe. If you are planning to get pregnant, it is better to examine and screen your thyroid, especially in relation to its hypofunction.

https://jmedicalcasereports.biomedcentral.com/articles/10.1186/s13256-021-02698-5 https://neoreviews.aappublications.org/content/3/1/e3?download=true **Dr. Saeed Bitarafan, Pediatric Cardiologist and Fetal Echocardiologist**