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Newborn infants of diabetics
164
NEWBORN INFANTS oF DIABETICS R. Hatcher, PhD; P. Barglow, MD; J. Burns, PhD Over the past twenty years several investigators have reported an increased incidence of developmental disturbances among offspring of diabetic women. Newborn hypoglycemia and maternal acetonuria have been associated with lowered ~Q and neurological abnormality in early childhood. The purpose of this study was to assess the impact of well-controlled maternal diabetes on newborn behavioral organization. The authors attempted to control for confounding gestational and perinatal factors that might influence outcome. The subjects of this study were 55 full term healthy infants of diabetics (IDMS) and their 13 normal controls. Infants were selected from the larger sample of 176 IDMs if they were delivered at term, if there was po evidence of asphyxia, if cord pH levels were greater than or equal to 1.20 and if there were no neonatal ~llnesses. Only infants whose mothers were free of anesthetic and analgesic agents during the 12 hours prior to delivery were chosen. Infants were seen on the second or third day of life by examiners trained to reliability with the Brazelton Neonatal Behavioral Assessment Scale. Cluster analysis found no significant differences between subjects and controls, but individual items differences related to state regulation and arousal were noted. These included the pinprick item (p=.006~ the self-quietlng item (p=.013), and borderline significant findings~inthe initial (p=.088) and secondary (p=.087) predominant state items, in the lability of skin color (p=.055) and hand-mouth facility items (p=.059). These findings while less pathological than those reported elsewhere by Yogman and by DiVitto and Goldberg suggest that even a scrupulously controlled pregnant diabetic milieu exerts a subtle yet persistent effect on newborn behavioral status, and that even healthy newborn IDMs may well be less responsive to their caretakers than normal infants.
NEWBORN INFANTS oF DIABETICS R. Hatcher, PhD; P. Barglow, MD; J. Burns, PhD Over the past twenty years several investigators have reported an increased incidence of developmental disturbances among offspring of diabetic women. Newborn hypoglycemia and maternal acetonuria have been associated with lowered ~Q and neurological abnormality in early childhood. The purpose of this study was to assess the impact of well-controlled maternal diabetes on newborn behavioral organization. The authors attempted to control for confounding gestational and perinatal factors that might influence outcome. The subjects of this study were 55 full term healthy infants of diabetics (IDMS) and their 13 normal controls. Infants were selected from the larger sample of 176 IDMs if they were delivered at term, if there was po evidence of asphyxia, if cord pH levels were greater than or equal to 1.20 and if there were no neonatal ~llnesses. Only infants whose mothers were free of anesthetic and analgesic agents during the 12 hours prior to delivery were chosen. Infants were seen on the second or third day of life by examiners trained to reliability with the Brazelton Neonatal Behavioral Assessment Scale. Cluster analysis found no significant differences between subjects and controls, but individual items differences related to state regulation and arousal were noted. These included the pinprick item (p=.006~ the self-quietlng item (p=.013), and borderline significant findings~inthe initial (p=.088) and secondary (p=.087) predominant state items, in the lability of skin color (p=.055) and hand-mouth facility items (p=.059). These findings while less pathological than those reported elsewhere by Yogman and by DiVitto and Goldberg suggest that even a scrupulously controlled pregnant diabetic milieu exerts a subtle yet persistent effect on newborn behavioral status, and that even healthy newborn IDMs may well be less responsive to their caretakers than normal infants.