LONG-TERM DEVELOPMENTAL FOLLOW-UP OF INFANTS OF DIABETIC MOTHERS

The neurodevelopmental consequences of maternal insulin-dependent diab etes were studied in 109 infants of diabetic mothers and 90 control in fants. The infants born to diabetic mothers included 70 ''early entry' ' subjects and 39 ''late entry'' subjects. Maternal diabetes control d uring pregnancy was significantly better in ''early entry'' mothers th an in late-entry mothers, as determined by glycosylated hemoglobin lev els. Infants were examined by a psychologist and a developmental pedia trician unaware of group status at 6, 12, 24, and 36 months of age; 71 % of the subjects completed the 3-year study. Neurodevelopment of earl y-entry subjects was similar to that of control subjects, whereas late -entry subjects scored less well on language measures. Mean head size in late-entry subjects was significantly less (p = 0.03) than in eithe r control subjects or early-entry subjects at age 3 years, and correla ted negatively with glycosylated hemoglobin levels during all three tr imesters. Less optimal intellectual development was associated with re duced, head circumference. In addition, the presence of major congenit al malformations was associated with reduced developmental performance through age 2 years. Our results indicate that mothers with insulin-d ependent diabetes who maintain good control during pregnancy can expec t to have infants who are neurodevelopmentally normal; mothers whose d iabetes is less well controlled may have infants with less optimal neu rodevelopment.