الفهرس 
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Abstract
Our study was conducted on 80 neonates, where forty neonates were macrosomic and other forty were controls, careful history was taken from parents, echo study was done for all neonates included in our study, cord blood concentration of cardiotrophine-1 was also measured. Our study was prospective study; neonates were delivered in Minia University Hospital, the duration was from March 2019 to December 2019.
Aim of work was evaluation of cardiac changes in Macrosomic neonatal infants through echocardiographic study and by measuring cord blood cardiotrophine-1 concentration.
Our study showed:
There were significant differences in weight, length, body surface area of macrosomic neonates than control at p <0.001 also there was significant increase in age, weight and body mass index in mothers of macrosomic neonates at p ꞊ 0.003, p<0.001, p <0.001 respectively.
There was a significant increase caesarian section among mothers of macrosomic neonates 33 (82.5%) versus 10 (25%) in mothers of controls (p <0.001)
Cord CT-1 level was significantly higher in macrosomic neonates than controls p<0.001. ASD was the commonest defect in our study present in eighteen (56.3%) of macrosomic neonates.
The increase in IVSD was highly significant in macrosomic neonates compared to control (Mean ± SD 0.6±0.2 versus 0.4±0.1 respectively p <0.001) but No differences between the groups were observed in LVESD, LVEDD, main pulmonary dimensions and LT pulmonary.
There were significant increase in TVR pressure gradient and PASP at macrosomic neonates than control (p<0.001).
A subgroup analysis (in the Macrosomic group) showed increased cord blood CT-1 concentrations in Macrosomic neonates with CHD, as compared to Macrosomic neonates without CHD (p1 =0.029).
Subgroup analysis (in the macrosomic group) showed increased cord blood CT-1 concentrations in IDM median 280(pg. /mL) as compared to controls median 59(pg. /mL) p2 <0.001 , also CT-1 levels were significantly elevated in macrosomic of IDM Median 280(pg. /mL) as compared to macrosomic of Non-diabetic mothers p1<0.001, but still significantly high in macrosomic neonates of Non-diabetic mothers [Median was 280 (pg. /mL)] versus( 59) in control p3<0.001.
CT-1 levels were similar in macrosomic with CHD and macrosomic without CHD neonates, and positively correlated with Infant RBS (r =0.949, r = 0.948 respectively p<0.001).
CT-1 levels were positively correlated with body surface area and birth weight in Macrosomic with CHD (r =0.888, r =0.800 respectively) and Macrosomic without CHD neonates (r =0.917, r =0.920 respectively).