Abstract
Although diabetes in pregnancy is thought to delay maturation of fetuses, its effects on neurophysical maturation have not been examined, especially in regard to the time of initiation of diabetic management. We tested the hypothesis that the diabetic intrauterine environment will retard the rate of fetal neurophysical maturation and that institution of maternal metabolic control before 9 wks of pregnancy (early) will reduce the maturation delay. Gestation was assessed in 104 infants of insulin dependent diabetic mothers (IDM) followed prospectively and in 221 infants of non-diabetic mothers (non-IDM), by standard clinical exam (Ballard, J. et al, 1979). Both groups had reliable obstetrically confirmed menstrual dates. At all gestations neurophysical maturity was advanced by 0.6 weeks in IDM when compared with non-IDM (p=0.005). Early institution of diabetic management in pregnancy (n=76) vs later (n=28) was not associated with change in rate of maturation. In the IDM group there was no effect of race, sex, or tobacco, alcohol, or coffee consumption on maturation. Lack of clinical RDS was associated with accelerated neurophysical maturation (p<0.003). We conclude that the diabetic intrauterine environment has an accelerating rather than retarding effect on gestational neuro-physical maturation; early institution of diabetic management does not affect the rate of intrauterine maturation.
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Ballard, J., Hertzberg, V., Holroyde, J. et al. NEUROPHYSICAL MATURATION IN IDM: EFFECT OF EARLY MATERNAL MANAGEMENT. Pediatr Res 18 (Suppl 4), 309 (1984). https://doi.org/10.1203/00006450-198404001-01299
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DOI: https://doi.org/10.1203/00006450-198404001-01299