[Somatic and psychomotor development of children of diabetic mothers in the 4th year in relation to neonatal findings].

Abstract

340 infants of mothers with type I diabetes (IDM) were examined during the neonatal period for gestational age, somatic data and clinical symptoms of diabetogenic foetopathy and assigned to one of three groups: group I--those whose weight development was delayed or appropriate for gestational age and without symptoms of foetopathy; group II--neonates who were overweight or of appropriate weight for their gestational age and who showed clear symptoms of foetopathy; group III--macrosomic infants (weight and length in advance of gestational age) without any major symptoms of foetopathy. In a pilot study preparing for more comprehensive follow up, 20 children from each group were examined in their fourth year to check their psychomotor and somatic development. To evaluate their growth additional data obtained on IDMs by correspondence were included. Although the group as whole showed a normal weight development for the fourth year with a low obesity rate (8.4%), the distribution among the three groups proved non-homogenous. 11.4% of the macrosomic children were overweight; this comprises 57% of all the obese children registered. There was a still clearer trend towards macrosomia among the children in groups II and III where the average age: length percentiles amounted to 57 and 67%. The psychological test showed an IQ of less than 95 in 16.7% of the cases distributed homogeneously among the different groups. With reference to their psychomotoric and language development the children examined were normal, some slight deviations in group II in walking and concentration ability need to be checked further. Our studies show that in children of diabetic mothers there are links between neonatal findings and later psychomotor and somatic development. A classification of newborns which goes beyond the usual establishment of percentiles for weight and gestational age seems appropriate in order to identify risk cases (macrosomia, obesity). A follow up study is required on a larger representative group and should be conducted at a more advanced age and not before the sixth year.