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Archives of Disease in Childhood. Fetal and Neonatal Edition logoLink to Archives of Disease in Childhood. Fetal and Neonatal Edition
. 1999 Jul;81(1):F10–F14. doi: 10.1136/fn.81.1.f10

Neurodevelopmental outcome at early school age of children born to mothers with gestational diabetes

A Ornoy, A Wolf, N Ratzon, C Greenbaum, M Dulitzky
PMCID: PMC1720965  PMID: 10375355

Abstract

AIMS—To study the metabolic derangements in the second half of pregnancy caused by gestational diabetes, on the long term development of children.
METHODS—The neuropsychological function of 32 school age children born to 32 mothers with well controlled gestational diabetes and 57 control children matched by age, birth order, and parental socioeconomic status was studied.
RESULTS—There were no differences in head circumference and height, but the children born to diabetic mothers were heavier. The verbal IQ scores of index children below the age of 9 years were lower than those of control children. No differences were found between the groups in various sensory and motor functions and in the Touwen and Prechtl neurological test. The young index group children performed less well than controls in fine and gross motor functions, as observed on the Bruininks-Oseretzky test of motor proficiency. The scores of young children born to mothers with gestational diabetes were also lower than controls on the Pollack tapper test, and there were more index group children who scored abnormally on the parents' Conners questionnaire. No correlation was found between the performance of the index group children on various neurodevelopmental tests and the severity of perinatal complications. The differences tended to disappear with age.
CONCLUSIONS—Gestational diabetes, as a result of the metabolic abnormalities in the second half of pregnancy, induces long term minor neurological deficits which are more pronounced in younger children. There does not seem to be any direct relation between the appearance of congenital anomalies and neurodevelopmental outcome.



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Selected References

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  1. Blumenthal S. A., Abdul-Karim R. W. Diagnosis, classification, and metabolic management of diabetes in pregnancy: therapeutic impact of self-monitoring of blood glucose and of newer methods of insulin delivery. Obstet Gynecol Surv. 1987 Oct;42(10):593–604. [PubMed] [Google Scholar]
  2. 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]
  3. Dobbing J., Sands J. Quantitative growth and development of human brain. Arch Dis Child. 1973 Oct;48(10):757–767. doi: 10.1136/adc.48.10.757. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Eskes T. K., Mooij P. N., Steegers-Theunissen R. P., Lips J. P., Pasker-de Jong P. C. Prepregnancy care and prevention of birth defects. J Perinat Med. 1992;20(4):253–265. doi: 10.1515/jpme.1992.20.4.253. [DOI] [PubMed] [Google Scholar]
  5. Goto M. P., Goldman A. S. Diabetic embryopathy. Curr Opin Pediatr. 1994 Aug;6(4):486–491. doi: 10.1097/00008480-199408000-00023. [DOI] [PubMed] [Google Scholar]
  6. Hod M., Diamant Y. Z. The offspring of a diabetic mother--short- and long-range implications. Isr J Med Sci. 1992 Feb;28(2):81–86. [PubMed] [Google Scholar]
  7. KARK S. L., PERITZ E., SHILOH A., SLOME C. EPIDEMIOLOGICAL ANALYSIS OF THE HEMOGLOBIN PICTURE IN PARTURIENT WOMEN OF JERUSALEM. Am J Public Health Nations Health. 1964 Jun;54:947–960. doi: 10.2105/ajph.54.6.947. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Lambert N. M., Sandoval J. The prevalence of learning disabilities in a sample of children considered hyperactive. J Abnorm Child Psychol. 1980 Mar;8(1):33–50. doi: 10.1007/BF00918160. [DOI] [PubMed] [Google Scholar]
  9. Metzger B. E., Silverman B. L., Freinkel N., Dooley S. L., Ogata E. S., Green O. C. Amniotic fluid insulin concentration as a predictor of obesity. Arch Dis Child. 1990 Oct;65(10 Spec No):1050–1052. doi: 10.1136/adc.65.10_spec_no.1050. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Miller E., Hare J. W., Cloherty J. P., Dunn P. J., Gleason R. E., Soeldner J. S., Kitzmiller J. L. Elevated maternal hemoglobin A1c in early pregnancy and major congenital anomalies in infants of diabetic mothers. N Engl J Med. 1981 May 28;304(22):1331–1334. doi: 10.1056/NEJM198105283042204. [DOI] [PubMed] [Google Scholar]
  11. Mills J. L., Baker L., Goldman A. S. Malformations in infants of diabetic mothers occur before the seventh gestational week. Implications for treatment. Diabetes. 1979 Apr;28(4):292–293. doi: 10.2337/diab.28.4.292. [DOI] [PubMed] [Google Scholar]
  12. Mills J. L., Knopp R. H., Simpson J. L., Jovanovic-Peterson L., Metzger B. E., Holmes L. B., Aarons J. H., Brown Z., Reed G. F., Bieber F. R. Lack of relation of increased malformation rates in infants of diabetic mothers to glycemic control during organogenesis. N Engl J Med. 1988 Mar 17;318(11):671–676. doi: 10.1056/NEJM198803173181104. [DOI] [PubMed] [Google Scholar]
  13. Mills J. L. Malformations in infants of diabetic mothers. Teratology. 1982 Jun;25(3):385–394. doi: 10.1002/tera.1420250316. [DOI] [PubMed] [Google Scholar]
  14. Miodovnik M., Mimouni F., Dignan P. S., Berk M. A., Ballard J. L., Siddiqi T. A., Khoury J., Tsang R. C. Major malformations in infants of IDDM women. Vasculopathy and early first-trimester poor glycemic control. Diabetes Care. 1988 Oct;11(9):713–718. doi: 10.2337/diacare.11.9.713. [DOI] [PubMed] [Google Scholar]
  15. Ornoy A., Ratzon N., Greenbaum C., Peretz E., Soriano D., Dulitzky M. Neurobehaviour of school age children born to diabetic mothers. Arch Dis Child Fetal Neonatal Ed. 1998 Sep;79(2):F94–F99. doi: 10.1136/fn.79.2.f94. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Ornoy A., Uriel L., Tennenbaum A. Inattention, hyperactivity and speech delay at 2-4 years of age as a predictor for ADD-ADHD syndrome. Isr J Psychiatry Relat Sci. 1993;30(3):155–163. [PubMed] [Google Scholar]
  17. 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]
  18. 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]
  19. 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]
  20. Rizzo T., Metzger B. E., Burns W. J., Burns K. Correlations between antepartum maternal metabolism and child intelligence. N Engl J Med. 1991 Sep 26;325(13):911–916. doi: 10.1056/NEJM199109263251303. [DOI] [PubMed] [Google Scholar]
  21. Silverman B. L., Landsberg L., Metzger B. E. Fetal hyperinsulinism in offspring of diabetic mothers. Association with the subsequent development of childhood obesity. Ann N Y Acad Sci. 1993 Oct 29;699:36–45. doi: 10.1111/j.1749-6632.1993.tb18835.x. [DOI] [PubMed] [Google Scholar]
  22. 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]

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