LONG-TERM PROSPECTIVE EVALUATION OF OFFSPRING OF DIABETIC MOTHERS
LONG-TERM PROSPECTIVE EVALUATION OF OFFSPRING OF DIABETIC MOTHERS
复制标题
DOI：
10.2337/diab.40.2.s121
复制
发表时间：
1991-12-01
期刊：
影响因子：
7.7
通讯作者：
METZGER, BE
中科院分区：
文献类型：
--
作者：
SILVERMAN, BL;RIZZO, T;METZGER, BE
我们认为，母亲代谢的改变可能会影响随后的人体测量和神经心理发育的儿童谁是在子宫内的母亲燃料经济性的干扰期间。本研究报告了糖尿病母亲（ODM）后代8岁时的体格发育和4岁时的神经心理发育。出生时，50%的婴儿体重>胎龄第90百分位数。到12个月时，身长和体重与一般人群相似。身高保持正常，直到7岁，当它变得略高于平均水平。5岁以后，相对体重急剧增加，到8岁时，有一半的ODM体重>第90百分位数。ODM儿童肥胖与母亲孕前体重相关，与妊娠32-38周羊水胰岛素无关。采用Brazelton新生儿行为评定量表（BNBAS）对185例ODM新生儿进行评定。显着相关性较差的中期和晚期妊娠血糖调节和低分数的新生儿BNBAS四个维度。对102名4岁的ODM儿童进行了Stanford-Binet智力测验。我们发现，儿童智商与孕中期和孕晚期母体脂质代谢（血清游离脂肪酸和β-羟基丁酸）呈负相关。围产期不良事件、社会经济状况、母亲智商、种族或糖尿病类型不能解释这种相关性。这些改变母体代谢和儿童生长发育之间的长期关联继续支持Freinkel的燃料介导的致畸作用假说。
We have suggested that altered maternal metabolism may effect the subsequent anthropometric and neuropsychological development of children who were in utero during disturbances in maternal fuel economy. This study reports the physical growth through 8 yr of age and the neuropsychological development through 4 yr of age in offspring of diabetic mothers (ODM). At birth, 50% of infants had weights > 90th percentile for gestational age. By 12 mo, length and weight were similar to the general population. Height remained normal until 7 yr of age, when it became slightly greater than average. After 5 yr of age, relative weight increased dramatically, and by 8 yr of age, half of the ODM had weights > 90th percentile. This childhood obesity in ODM is correlated with maternal prepregnant weight and independently with amniotic fluid insulin at 32-38 wk gestation. The Brazelton Neonatal Behavioral Assessment Scale (BNBAS) was administered to 185 newborn ODM. Significant correlations were found between poorer second- and third-trimester glycemic regulation and lower scores in three of four newborn BNBAS dimensions. The Stanford-Binet intelligence Scale was measured in 102 ODM at 4 yr of age. We found an inverse correlation between childhood IQ and second- and third-trimester maternal lipid metabolism (serum free fatty acids and beta-hydroxybutyrate). This correlation is not explained by adverse perinatal events, socioeconomic status, maternal IQ, ethnicity, or diabetes type. These long-range associations between altered maternal metabolism and childhood growth and development continue to support Freinkel's hypothesis of fuel-mediated teratogenesis.