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Developmental outcome of offspring of pregestational diabetic mothers
M Hod1, R Levy-Shiff, M Lerman
1Department of Obstetrics & Gynecology, Rabin Medical Center, Petah Tiqva, Israel.
Insights
Children born to mothers with pregestational diabetes mellitus (PGDM) show developmental delays. Even with good maternal metabolic control, these infants had lower scores in mental, psychomotor, and orientation development at one year.
Area of Science:
- Developmental Pediatrics
- Endocrinology
- Obstetrics
Background:
- Pregestational diabetes mellitus (PGDM) poses risks to fetal development.
- Maternal metabolic control is crucial but may not fully mitigate risks.
- Long-term developmental outcomes for offspring of mothers with PGDM require further investigation.
Purpose of the Study:
- To assess the one-year developmental outcomes of infants born to mothers with PGDM.
- To compare developmental trajectories between infants of mothers with and without PGDM.
- To identify potential differences in outcomes based on diabetes type (Type 1 vs. Type 2 DM).
Main Methods:
- Prospective evaluation of 31 mothers with PGDM (Type 1 and Type 2 DM) and 41 non-diabetic controls.
- Follow-up assessment of offspring development at one year of age.
- Utilized standardized developmental assessments including Mental Development Index (MDI) and Psychomotor Development Index (PDI) scores.
Main Results:
- Offspring of mothers with PGDM exhibited significantly lower scores in mental, psychomotor, and orientation/engagement development compared to controls.
- MDI and PDI scores were significantly lower in the PGDM group (91.04 vs 98.15, p<0.05 and 85.15 vs 95.54, p<0.05, respectively).
- Infants of mothers with Type 2 DM had lower PDI scores than Type 1 DM infants, but higher motor quality scores.
Conclusions:
- Maternal PGDM is associated with less favorable developmental outcomes in offspring at one year, irrespective of metabolic control.
- These findings highlight the need for comprehensive developmental surveillance in infants born to mothers with diabetes.
- Further large-scale studies are warranted to determine if these early differences persist and lead to later cognitive impairment.
Abstract:
The aim of this study was to investigate the one-year developmental outcome of offspring of mothers with pregestational diabetes mellitus (PGDM). We prospectively evaluated 31 women with PGDM (21 with type 1 DM and 10 with type 2 DM) and 41 nondiabetic controls during pregnancy and for one year follow-up. Data showed that offspring of mothers with PGDM scored lower than controls in all aspects of development--mental, psychomotor, and exploration/orientation. Despite the good metabolic control of the mothers with PGDM, their offpsring showed a less favorable developmental outcome at one year than infants of nondiabetic mothers. MDI score and PDI score were significantly lower in the diabetic group than in the controls (91.04 vs 98.15, p<0.05 and 85.15 vs 95.54, p<0.05, respectively). In addition, the orientation/engagement score was lower in the diabetic group as compared with the nondiabetic group (41.04 vs 45.50, p<0.05). Whereas no significant difference was found between the type 1 and type 2 groups with regard to the MDI score, type 2 infants scored lower on the PDI than infants in the type 1 group (78.1 vs 89.3) but higher on the motor quality score (34.0 vs 31.3). These preliminary findings support the need for ongoing large scale developmental follow-up studies of offspring born to diabetic mothers in order to elucidate whether they have cognitive impairment later in life.