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Archives of Disease in Childhood. Fetal and Neonatal Edition logoLink to Archives of Disease in Childhood. Fetal and Neonatal Edition
. 1998 Nov;79(3):F174–F179. doi: 10.1136/fn.79.3.f174

Long term neurological dysfunction and neonatal hypoglycaemia after diabetic pregnancy

E Stenninger, R Flink, B Eriksson, C Sahlen
PMCID: PMC1720863  PMID: 10194986

Abstract

AIM—To determine if children born to mothers with diabetes mellitus during pregnancy, who subsequently developed neonatal hypoglycaemia, experienced long term neurological dysfunction.
METHODS—Thirteen children with, and 15 without, neonatal hypoglycaemia (blood glucose < 1.5 mmol/l) were randomly selected from a larger cohort and investigated at the age of 8 years. They were also compared with 28 age matched healthy controls.
RESULTS—Children with neonatal hypoglycaemia had significantly more difficulties in a validated screening test for minimal brain dysfunction than controls and were also more often reported to be hyperactive, impulsive, and easily distracted. On psychological assessment, they had a lower total development score than normoglycaemic children born to diabetic mothers, and control children. 
CONCLUSIONS—Neonatal hypoglycaemia in diabetic pregnancy was associated with long term neurological dysfunction related to minimal brain dysfunction/deficits in attention, motor control, and perception.



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Selected References

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  1. BROWN R. J., WALLIS P. G. Hypoglycaemia in the newborn infant. Lancet. 1963 Jun 15;1(7294):1278–1282. doi: 10.1016/s0140-6736(63)91981-0. [DOI] [PubMed] [Google Scholar]
  2. Bjørgaas M., Sand T., Gimse R. Quantitative EEG in type 1 diabetic children with and without episodes of severe hypoglycemia: a controlled, blind study. Acta Neurol Scand. 1996 Jun;93(6):398–402. doi: 10.1111/j.1600-0404.1996.tb00017.x. [DOI] [PubMed] [Google Scholar]
  3. Breidahl H. D. The growth and development of children born to mothers with diabetes. Med J Aust. 1966 Feb 12;1(7):268–270. doi: 10.5694/j.1326-5377.1966.tb19702.x. [DOI] [PubMed] [Google Scholar]
  4. CORNBLATH M., ODELL G. B., LEVIN E. Y. Symptomatic neonatal hypoglycemia associated with toxemia of pregnancy. J Pediatr. 1959 Nov;55:545–562. doi: 10.1016/s0022-3476(59)80239-0. [DOI] [PubMed] [Google Scholar]
  5. Churchill J. A., Berendes H. W., Nemore J. Neuropsychological deficits in children of diabetic mothers. A report from the Collaborative Sdy of Cerebral Palsy. Am J Obstet Gynecol. 1969 Sep 15;105(2):257–268. doi: 10.1016/0002-9378(69)90067-2. [DOI] [PubMed] [Google Scholar]
  6. Cornblath M., Schwartz R., Aynsley-Green A., Lloyd J. K. Hypoglycemia in infancy: the need for a rational definition. A Ciba Foundation discussion meeting. Pediatrics. 1990 May;85(5):834–837. [PubMed] [Google Scholar]
  7. Cummins M., Norrish M. Follow-up of children of diabetic mothers. Arch Dis Child. 1980 Apr;55(4):259–264. doi: 10.1136/adc.55.4.259. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Farquhar J. W. Prognosis for babies born to diabetic mothers in Edinburgh. Arch Dis Child. 1969 Feb;44(233):36–47. doi: 10.1136/adc.44.233.36. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Fluge G. Neurological findings at follow-up in neonatal hypoglycaemia. Acta Paediatr Scand. 1975 Jul;64(4):629–634. doi: 10.1111/j.1651-2227.1975.tb03894.x. [DOI] [PubMed] [Google Scholar]
  10. Gerlini G., Arachi S., Gori M. G., Gloria F., Bonci E., Pachi A., Zuccarini O., Fiore R., Fallucca F. Developmental aspects of the offspring of diabetic mothers. Acta Endocrinol Suppl (Copenh) 1986;277:150–155. doi: 10.1530/acta.0.111s0150. [DOI] [PubMed] [Google Scholar]
  11. Gillberg C., Carlström G., Rasmussen P., Waldenström E. Perceptual, motor and attentional deficits in seven-year-old children. Neurological screening aspects. Acta Paediatr Scand. 1983 Jan;72(1):119–124. doi: 10.1111/j.1651-2227.1983.tb09675.x. [DOI] [PubMed] [Google Scholar]
  12. Gillberg C., Rasmussen P. Perceptual, motor and attentional deficits in six-year-old children. Screening procedure in pre-school. Acta Paediatr Scand. 1982 Jan;71(1):121–129. doi: 10.1111/j.1651-2227.1982.tb09382.x. [DOI] [PubMed] [Google Scholar]
  13. Gillberg C., Rasmussen P. Studie i Göteborg. MBD hos sex- och sjuåringar kan spåras med enkla diagnoshjälpmedel. Lakartidningen. 1982 Nov 24;79(47):4413-4, 4419. [PubMed] [Google Scholar]
  14. Griffiths A. D., Bryant G. M. Assessment of effects of neonatal hypoglycaemia. A study of 41 cases with matched controls. Arch Dis Child. 1971 Dec;46(250):819–827. doi: 10.1136/adc.46.250.819. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. HAGBARD L., OLOW I., REINAND T. A follow-up study of 514 children of diabetic mothers. Acta Paediatr. 1959 Mar;48(2):184–197. [PubMed] [Google Scholar]
  16. HAWORTH J. C., MCRAE K. N. THE NEUROLOGICAL AND DEVELOPMENTAL EFFECTS OF NEONATAL HYPOGLYCEMIA: A FOLLOW-UP OF 22 CASES. Can Med Assoc J. 1965 Apr 17;92:861–865. [PMC free article] [PubMed] [Google Scholar]
  17. Haworth J. C., McRae K. N., Dilling L. A. Prognosis of infants of diabetic mothers in relation to neonatal hypoglycaemia. Dev Med Child Neurol. 1976 Aug;18(4):471–479. doi: 10.1111/j.1469-8749.1976.tb03686.x. [DOI] [PubMed] [Google Scholar]
  18. Hod M., Rabinerson D., Kaplan B., Peled Y., Bar J., Shindel B., Merlob P., Ovadia J., Neri A. Perinatal complications following gestational diabetes mellitus how 'sweet' is ill? Acta Obstet Gynecol Scand. 1996 Oct;75(9):809–815. doi: 10.3109/00016349609054708. [DOI] [PubMed] [Google Scholar]
  19. Koh T. H., Aynsley-Green A., Tarbit M., Eyre J. A. Neural dysfunction during hypoglycaemia. Arch Dis Child. 1988 Nov;63(11):1353–1358. doi: 10.1136/adc.63.11.1353. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Koh T. H., Eyre J. A., Aynsley-Green A. Neonatal hypoglycaemia--the controversy regarding definition. Arch Dis Child. 1988 Nov;63(11):1386–1388. doi: 10.1136/adc.63.11.1386. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Koivisto M., Blanco-Sequeiros M., Krause U. Neonatal symptomatic and asymptomatic hypoglycaemia: a follow-up study of 151 children. Dev Med Child Neurol. 1972 Oct;14(5):603–614. doi: 10.1111/j.1469-8749.1972.tb02642.x. [DOI] [PubMed] [Google Scholar]
  22. Kuperman S., Johnson B., Arndt S., Lindgren S., Wolraich M. Quantitative EEG differences in a nonclinical sample of children with ADHD and undifferentiated ADD. J Am Acad Child Adolesc Psychiatry. 1996 Aug;35(8):1009–1017. doi: 10.1097/00004583-199608000-00011. [DOI] [PubMed] [Google Scholar]
  23. Lucas A., Morley R., Cole T. J. Adverse neurodevelopmental outcome of moderate neonatal hypoglycaemia. BMJ. 1988 Nov 19;297(6659):1304–1308. doi: 10.1136/bmj.297.6659.1304. [DOI] [PMC free article] [PubMed] [Google Scholar]
  24. McKinna A. J. Neonatal hypoglycemia--some ophthalmic observations. Can J Ophthalmol. 1966 Jan;1(1):56–59. [PubMed] [Google Scholar]
  25. Naeye R. L. The outcome of diabetic pregnancies: a prospective study. 1978 Mar 30-Apr 1Ciba Found Symp. (63):227–241. doi: 10.1002/9780470720462.ch11. [DOI] [PubMed] [Google Scholar]
  26. Persson B., Gentz J. Follow-up of children of insulin-dependent and gestational diabetic mothers. Neuropsychological outcome. Acta Paediatr Scand. 1984 May;73(3):349–358. doi: 10.1111/j.1651-2227.1994.tb17747.x. [DOI] [PubMed] [Google Scholar]
  27. Petersen M. B., Pedersen S. A., Greisen G., Pedersen J. F., Mølsted-Pedersen L. Early growth delay in diabetic pregnancy: relation to psychomotor development at age 4. Br Med J (Clin Res Ed) 1988 Feb 27;296(6622):598–600. doi: 10.1136/bmj.296.6622.598. [DOI] [PMC free article] [PubMed] [Google Scholar]
  28. Rasmussen P., Gillberg C. Perceptual, motor and attentional deficits in seven-year-old children. Paediatric aspects. Acta Paediatr Scand. 1983 Jan;72(1):125–130. doi: 10.1111/j.1651-2227.1983.tb09676.x. [DOI] [PubMed] [Google Scholar]
  29. Rizzo T. A., Dooley S. L., Metzger B. E., Cho N. H., Ogata E. S., Silverman B. L. Prenatal and perinatal influences on long-term psychomotor development in offspring of diabetic mothers. Am J Obstet Gynecol. 1995 Dec;173(6):1753–1758. doi: 10.1016/0002-9378(95)90422-0. [DOI] [PubMed] [Google Scholar]
  30. Rizzo T. A., Ogata E. S., Dooley S. L., Metzger B. E., Cho N. H. Perinatal complications and cognitive development in 2- to 5-year-old children of diabetic mothers. Am J Obstet Gynecol. 1994 Sep;171(3):706–713. doi: 10.1016/0002-9378(94)90086-8. [DOI] [PubMed] [Google Scholar]
  31. Rizzo T. A., Silverman B. L., Metzger B. E., Cho N. H. Behavioral adjustment in children of diabetic mothers. Acta Paediatr. 1997 Sep;86(9):969–974. doi: 10.1111/j.1651-2227.1997.tb15181.x. [DOI] [PubMed] [Google Scholar]
  32. Sells C. J., Robinson N. M., Brown Z., Knopp R. H. Long-term developmental follow-up of infants of diabetic mothers. J Pediatr. 1994 Jul;125(1):S9–17. doi: 10.1016/s0022-3476(94)70170-9. [DOI] [PubMed] [Google Scholar]
  33. Silverman B. L., Rizzo T., Green O. C., Cho N. H., Winter R. J., Ogata E. S., Richards G. E., Metzger B. E. Long-term prospective evaluation of offspring of diabetic mothers. Diabetes. 1991 Dec;40 (Suppl 2):121–125. doi: 10.2337/diab.40.2.s121. [DOI] [PubMed] [Google Scholar]
  34. Stehbens J. A., Baker G. L., Kitchell M. Outcome at ages 1, 3, and 5 years of children born to diabetic women. Am J Obstet Gynecol. 1977 Feb 15;127(4):408–413. doi: 10.1016/0002-9378(77)90499-9. [DOI] [PubMed] [Google Scholar]
  35. Stenninger E., Schollin J., Aman J. Neonatal macrosomia and hypoglycaemia in children of mothers with insulin-treated gestational diabetes mellitus. Acta Paediatr Scand. 1991 Nov;80(11):1014–1018. doi: 10.1111/j.1651-2227.1991.tb11776.x. [DOI] [PubMed] [Google Scholar]
  36. Weintrob N., Karp M., Hod M. Short- and long-range complications in offspring of diabetic mothers. J Diabetes Complications. 1996 Sep-Oct;10(5):294–301. doi: 10.1016/1056-8727(95)00080-1. [DOI] [PubMed] [Google Scholar]
  37. Weitz R., Laron Z. Height and weight of children born to mothers with diabetes mellitus. Isr J Med Sci. 1976 Mar;12(3):195–198. [PubMed] [Google Scholar]

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