Early malnutrition and child neurobehavioral development: insights from the study of children of diabetic mothers

Abstract

In this study we sought to discern whether disturbances in mothers' metabolism during pregnancy may exert long-range effects on the neurobehavioral development of the progeny. Participants were 139 women with diabetes in pregnancy and their singleton offspring. Serial estimates of circulating maternal fuels were obtained for each pregnancy, along with detailed records of perinatal course and outcome. Offspring were administered the Wechsler Intelligence Scale for Children--Revised (WISC-R) and Kaufman Test of Educational Achievement: Short Form (KTEA) at ages 7 to 11 years. The rate of WISC-R full-scale IQ scores below 70 in our cohort did not differ significantly from national estimates. Nonetheless, after statistically controlling for other influences, WISC-R verbal, performance, and full-scale IQ scores, and Bannatyne's indices of Verbal Conceptualization Ability, Acquired knowledge, Spatial Ability, and Sequencing Ability were inversely correlated with measures of maternal lipid and glucose metabolism in the second and third trimesters. KTEA Arithmetic scores were similarly correlated with measures of maternal lipids in the third trimester. All correlations indicate that poorer maternal metabolic regulation was attended by poorer child performance. The effects of maternal metabolism on fetal brain and neurobehavioral development are discussed as potential intermediary factors.