Abstract
Infants of diabetic mothers (IDM) are at a risk for congenital anomalies and long term neurological/developmental dysfunction. In a prospective longitudinal study, IDMs born to mothers randomly assigned during the first trimester of pregnancy to Group I -strict diabetes management- or Group II -customary diabetes management-were evaluated to examine treatment impact on short and long term outcome. Thirty-four infants have been followed for 2 years with repeat neurological and psychological assessments. At birth, Group I IDMs had a larger head circumference (t=2.67, p<.01) and were longer (t=2.11, p<.05) than Group II infants. At 8 and 12 months, Bayley mental indices (MDI) were higher for Group I (MDI-111 and 110 respect.) than Group II (MDI=99 and 103 respect.). T-tests and F values were significant at <.01 and <.05 levels respect. There were no differences for Bayley motor indices PDI (Group I, PDI=102 and 109; for Group II, PDI=102 and 104). Differences had disappeared at 18 and 24 month. White classification correlated with poor neurological performance using the Amiel-Tison neurological assessment at 12 months (R=.33, p <.10). Thus, it appears that IDMs born to mothers with strict diabetes management in early pregnancy have a better short term prognosis for mental and neurological outcome. Long term follow-up of more IDMs now in progress is necessary: (1) To obtain a more detailed picture of subtle neuro/developmental delay in the IDM. (2) To assess whether early mental scores and neurological signs are indicators of functional/intellectual deficits in later life; and whether early first trimester strict diabetes management has a positive effect on long term outcome.
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Steichen, J., Steichen Asch, P. & Tsang, R. PREGNANCY MANAGEMENT OF DIABETES AND TWO YEAR NEURO/DEVELOPMENTAL OUTCOME OF INFANTS OF DIABETIC MOTHERS. Pediatr Res 21 (Suppl 4), 184 (1987). https://doi.org/10.1203/00006450-198704010-00109
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DOI: https://doi.org/10.1203/00006450-198704010-00109