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. 2025 Jan:276:114319.
doi: 10.1016/j.jpeds.2024.114319. Epub 2024 Sep 19.

Maternal Diabetes and Neurodevelopmental Outcomes of Infants Born Before 29 Weeks' Gestation

Adetokunbo Akinseye  1 , Christy Pylypjuk  2 , Diane Moddemann  3 , Jehier Afifi  4 , Rudaina Banihani  5 , Khalid Aziz  6 , Dianna Wang  6 , Mary Seshia  7 ; Canadian Neonatal Network, Canadian Neonatal Follow-Up Network under the Umbrella of Canadian Preterm Birth Network
Collaborators, Affiliations

Maternal Diabetes and Neurodevelopmental Outcomes of Infants Born Before 29 Weeks' Gestation

Adetokunbo Akinseye et al. J Pediatr. 2025 Jan.

Abstract

Objective: To compare the neurodevelopmental outcomes of infants born at <29 weeks' gestation and exposed to diabetes in pregnancy with those unexposed.

Study design: This was a retrospective cohort study using the Canadian Neonatal Network and Canadian Neonatal Follow-Up Network databases. Infants born <29 weeks' gestation and admitted to a level 3 neonatal intensive care unit from 2009 through 2018 who had neurodevelopmental assessments at 18-24 months corrected age were eligible. The 2 primary outcomes were as follows: (1) Neurodevelopmental impairment (NDI) (≥1 of Bayley-III scores < 85 in any domain, cerebral palsy, or vision or hearing impairment); and (2) significant NDI (sNDI) (≥1 of Bayley-III scores < 70 in any domain, cerebral palsy Gross Motor Function Classification System ≥ 3, bilateral blindness, or need for hearing aids or cochlear implants). Secondary outcomes were the individual components of NDI and sNDI. Adjusted odds ratios with 95% CIs were calculated to determine outcomes between groups.

Results: Of 13 988 eligible infants, 55% attended neurodevelopmental follow-up assessments. Infants exposed to diabetes had increased odds of NDI compared with those unexposed (aOR 1.09 (95% CI 1.08-1.54); there was no difference in sNDI (aOR 1.07 (95% CI 0.84-1.36). Language and motor delays were more common in those exposed to maternal diabetes.

Conclusions: Higher rates of NDI, language, or motor delays were present in infants born at <29 weeks' gestation exposed to diabetes in utero. Future research is needed to determine the etiology and clinical significance of these findings.

Keywords: maternal diabetes; neurodevelopmental outcomes; preterm.

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Conflict of interest statement

Declaration of Competing Interest Although, there are no specific study sponsors, organizational support for the Canadian Neonatal Network and the Canadian Neonatal Follow-up Network was provided by the Maternal-infant Care Research Center (MiCare) at Mount Sinai Hospital in Toronto, Ontario, Canada. MiCare is supported by the Canadian Institutes of Health Research (CTP 87518) and Mount Sinai Hospital. The funding bodies had no role in the design, or conduct of the study; the collection, management, analysis, or interpretation of the data; the preparation, review, or approval of the manuscript; or the decision to submit the manuscript for publication. The authors declare no conflicts of interest.

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