Correlations between antepartum maternal metabolism and intelligence of offspring

Article Abstract:

To evaluate the effect of maternal metabolism on the early intellectual development of children, a study was carried out of 223 pregnant women who underwent metabolic testing during the second and third trimesters of pregnancy. A key idea underlying the study was the possibility that maternal fuels affect fetal cells during critical periods of development and that abnormal metabolism may result in defective development. Eighty-nine women had diabetes mellitus (diagnosed before pregnancy); 99 had gestational diabetes mellitus (developed during pregnancy); and 35 had normal glucose (sugar) metabolism. The subjects were given prenatal care according to a detailed protocol and were treated for diabetes according to standard care guidelines. Blood samples were drawn at regular intervals for evaluation of metabolism. Infants' metabolism was evaluated for several hours after birth. At the age of two and at least once again before the age of five, the children underwent intelligence testing with standard tests. An average IQ score for all three years was calculated. Results showed that mothers' plasma beta-hydroxybutyrate levels (related to lipid metabolism) in the last trimester of pregnancy were inversely related to the children's mental-development-index scores at the age of two years, and that these same levels, plus those of free fatty acids, were also inversely correlated with Stanford-Binet scores (one of the intelligence tests). No other relationships between maternal metabolic measures and child development were found. A review of the medical literature concerning such relationships is presented. The results are interpreted to indicate the importance of intrauterine metabolic effects for the behavioral and intellectual functioning of toddlers and preschool-aged children. Efforts should be made to avoid ketoacidosis and accelerated starvation among all pregnant women. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Care and treatment, Complications and side effects, Pregnant women, Pregnancy, Child development, Prenatal influences, Intelligence (Psychology), Intellect

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Accelerated starvation in late pregnancy: a comparison between obese women with and without gestational diabetes mellitus

Article Abstract:

A diagnosis of gestational diabetes, pregnancy-induced sugar intolerance, is made on the basis of results of blood tests performed after the woman has been fed. However, food may fail to stimulate the secretion of insulin, the hormone essential for sugar metabolism. Accelerated starvation is a term used to describe the rapid breakdown of fats at the end of a normal pregnancy. It occurs when insulin levels fall, calling on hormones to mobilize fats. It is not known whether women with gestational diabetes also experience this physiological phenomenon. To see if accelerated starvation is exaggerated in women with gestational diabetes, glucose, insulin and fats were measured following an overnight fast. Measurements were made in 10 obese pregnant women with gestational diabetes and 10 similar women without. At 12 hours, the glucose, insulin and free fatty acids were higher in the women with gestational diabetes. When the women were not given breakfast, which extended their fasting to 18 hours, the amount of glucose remained high in the women without diabetes but decreased rapidly in the women with diabetes. The insulin levels decreased similarly in diabetic and nondiabetic women. The amount of free fatty acids did not increase significantly in the diabetic women, but in the women without diabetes the amount increased by 44 percent. Therefore, diabetic and nondiabetic women responded differently to a brief fast. The glucose fell faster in diabetic women without a rise in free fatty acids than in the women without diabetes. Since a rise in fatty acids can cause complications in the fetus, dietary management of diabetic obese patients by restricted caloric intake may have important implications. (Consumer Summary produced by Reliance Medical Information, Inc.)

Causes of, Physiological aspects, Pregnancy, Complications of, Pregnancy complications, Fasting, Ketoacidosis, Diabetic ketoacidosis

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