Neurodevelopmental outcome at 1 year in offspring of women with gestational diabetes mellitus

Abstract

Objective

To study the metabolic derangements in the second half of pregnancy caused by gestational diabetes mellitus(GDM), on the short term neurodevelopment of infants.

Design

A prospective cohort study of 555 mother–child pairs were recruited, which included 177 GDM patients and 378 pregnant women with normal glucose tolerance as controls. Clinical and demographic characteristics were obtained at enrollment, birth and follow-up. Neurodevelopment was examined with the Bayley Scales of Infant Development V.1 mental development index (MDI) and psychomotor development index (PDI). Fatty acids (FA) were analyzed by gas chromatography mass spectrometry (GC-MS).

Results

Statistically significant differences were found between the two groups in fasting plasma glucose (FPG) and triglyceride (TG). The scores of MDI and PDI of control group were higher than those of GDM group. The regression analysis showed that maternal age and saturated fatty acid (SFA) were independently associated with lower scores on the MDI whereas gestational age and docosahexaenoic acid (DHA) were associated with higher scores; in addition, lower scores on the PDI were associated with FPG and neonatal weigh associated with higher scores.

Conclusion

SFA, DHA and FPG as indicators of lipid metabolism were associated with neurodevelopmental outcome at 1 year in offspring of women with gestational diabetes mellitus. Control the level of blood glucose and lipid during pregnancy and the appropriate supplementation of DHA during pregnancy in the second half of pregnancy may be beneficial to the neurodevelopment of infants.

摘要

目标：研究妊娠期糖尿病（GDM）引起的妊娠后半期代谢紊乱对婴儿短期神经发育的影响。

设计：一项前瞻性队列研究, 纳入了555对母子, 其中包括177名GDM患者和378名糖耐量正常的孕妇作为对照。获取入组, 出生和随访时的临床和人口统计学特征。用贝利婴儿发展量表V.1智力发展指数（MDI）和心理运动发展指数（PDI）检测神经发育。通过气相色谱质谱法（GC-MS）分析脂肪酸（FA）。

结果：两组的空腹血浆葡萄糖（FPG）和甘油三酸酯（TG）水平有显著统计学差异。对照组MDI及PDI得分高于GDM组。回归分析显示：产妇年龄和饱和脂肪酸（SFA）与MDI得分较低独立相关, 而胎龄和二十二碳六烯酸（DHA）与得分较高相关; 此外, PDI得分较低与FPG相关, 而新生儿体重与得分较高相关。

结论：SFA, DHA和FPG作为脂代谢指标与妊娠糖尿病妇女子代1岁时的神经发育结局相关。在孕期控制血糖和血脂水平, 在妊娠后半期适当补充DHA可能对婴儿的神经发育有利。

Keywords:

• Gestational diabetes
• infant neurodevelopment
• lipid metabolism

Author contributions

Rui-xue Dai and Chao-qing Tian, contributed to conception or design, drafted the manuscript, gave final approval and Agrees to be accountable for all aspects of work ensuring integrity and accuracy; Xiujie He: contributed to acquisition, analysis, or interpretation, critically revised the manuscript, gave final approval and Agrees to be accountable for all aspects of work ensuring integrity and accuracy; Chuanlai Hu, contributed to conception or design, critically revised the manuscript, gave final approval and Agrees to be accountable for all aspects of work ensuring integrity and accuracy.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported by the National Natural Science Foundation of China [grant number 81373011]. The National Natural Science Foundation of China had no role in the design, analysis or writing of this article.