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Evaluating the effects of maternal diabetes on early infant neurodevelopment with a novel combination of four
Alexa Escapita1, Alexandra Glatter2, Eric Siegel3
1University of Arkansas for Medical Sciences, Department of Obstetrics and Gynecology, Little Rock, AR, USA.
Insights
Maternal diabetes may impact infant neurodevelopment. While not statistically significant, trends suggest lower language scores in infants of mothers with type 1 diabetes and visual-motor delays in infants of mothers with type 2 diabetes.
Area of Science:
- Neuroscience
- Developmental Pediatrics
- Endocrinology
Background:
- Maternal diabetes mellitus is linked to neurodevelopmental disorders in offspring.
- Understanding the specific impacts of type 1 (T1DM) and type 2 (T2DM) diabetes on infant neurodevelopment is crucial.
Purpose of the Study:
- To characterize the neurodevelopmental effects of maternal T1DM and T2DM in infants.
- To compare neurodevelopmental outcomes across infants of mothers with T1DM, T2DM, and non-diabetic controls.
Main Methods:
- Prospective study of 54 infants (1-2 months old) from mothers with T1DM (n=10), T2DM (n=24), and controls (n=20).
- Utilized Hammersmith Neonatal Neurological Examination (HNNE), Dubowitz exam, Capute Scales, and General Movement Assessment (GMA).
Main Results:
- No statistically significant differences in neurodevelopmental outcomes were found across groups.
- Trends indicated lower language scores in the T1DM group and more abnormal writhing movements in the T2DM group (GMA).
- Suboptimal neuromotor development was observed in 20 infants.
Conclusions:
- Findings suggest potential trends of lower language scores in infants exposed to T1DM and lower visual-motor scores in infants exposed to T2DM.
- Early identification and developmental therapy are recommended for infants of mothers with diabetes.
- Further research with larger sample sizes is needed to confirm these preliminary findings.
Abstract:
There are associations between maternal diabetes and neurodevelopmental disorders, such as autism spectrum disorders, attention-deficit/hyperactivity disorder, and intellectual disabilities. Using this knowledge, our objective is to characterize the effects of type 1 (T1DM) and type 2 diabetes mellitus (T2DM) on the neurodevelopment of infants. We performed a prospective study on 54 infants of mothers with T1DM (n = 10), T2DM (n = 24), and non-diabetic controls (n = 20). To evaluate their neurodevelopment in multiple developmental domains, we used four assessments on 1-2-month-old infants: The Hammersmith Neonatal Neurological Examination (HNNE), The Dubowitz exam, The Capute Scales, and The General Movement Assessment (GMA). Differences in neurodevelopmental outcomes did not reach statistical significance in any of the four assessments, individually or combined. However, we note the following trends: 20 infants had suboptimal neuromotor development (HNNE score < 30.5). T1DM group infants had lower mean language scores (83.7 vs 105.85) when compared to the control group. Using GMA, T2DM group infants had more abnormal writhing movements when compared to the other groups. Our overall findings suggest that the T1DM group had lower language scores and the T2DM group had lower visual-motor (cognitive) scores which may indicate developmental delays. Further research is needed to confirm these findings. We suggest that these infant's parents consider developmental therapy, to promote early identification and treatment of potential developmental delays. To our knowledge this study would be the first to use the combination of these assessments to evaluate 1-month-olds in this patient population. Given the small sample size, these findings should be interpreted with caution.
