Video-EEG recordings in full-term neonates of diabetic mothers: observational study

Arch Dis Child Fetal Neonatal Ed. 2013 Nov;98(6):F493-8. doi: 10.1136/archdischild-2013-304283. Epub 2013 Jul 19.

Abstract

Objective: To determine whether full-term newborn infants of diabetic mothers (IDM) present immature/disorganised EEG patterns in the immediate neonatal period, and whether there was any relationship with maternal glycaemic control.

Design and setting: Cohort study with an incidental sample performed in a tertiary hospital neonatal unit.

Patients: 23 IDM and 22 healthy newborns born between 2010 and 2013.

Interventions: All underwent video-EEG recording lasting >90 min at 48-72 h of life.

Main outcome measures: We analysed the percentage of indeterminate sleep, transient sharp waves per hour and mature-for-gestational age EEG patterns (discontinuity, maximum duration of interburst interval (IBI), asynchrony, asymmetry, δ brushes, encoches frontales and α/θ rolandic activity). The group of IDM was divided into two subgroups according to maternal HbA1c: (1) HbA1c≥6% and (2) HbA1c<6%.

Results: Compared with healthy newborns, IDM presented significantly higher percentage of indeterminate sleep (57% vs 25%; p<0.001), discontinuity (2.5% vs 0%; p=0.044) and δ brushes in the bursts (6% vs 3%; p=0.024); higher duration of IBI (0.3 s vs 0 s; p=0.017); fewer encoches frontales (7/h vs 35/h; p<0.001), reduced θ/α rolandic activity (3/h vs 9/h; p<0.001); and more transient sharp waves (25/h vs 5/h; p<0.001). IDM with maternal HbA1c≥6% showed greater percentage of δ brushes in the burst (14% vs 4%; p=0.007).

Conclusions: Full-term IDM newborns showed video-EEG features of abnormal development of brain function. Maternal HbA1c levels<6% during pregnancy could minimise the risk of cerebral dysmaturity.

Keywords: Clin Neurophysiology; Diabetes; Fetal Medicine; Neonatology; Neurodevelopment.

Publication types

  • Observational Study

MeSH terms

  • Blood Glucose / metabolism
  • Brain / physiopathology
  • Brain Diseases / blood
  • Brain Diseases / diagnosis*
  • Brain Diseases / physiopathology
  • Child Development
  • Cohort Studies
  • Diabetes Mellitus, Type 1 / blood
  • Diabetes Mellitus, Type 1 / diagnosis*
  • Diabetes, Gestational / blood
  • Diabetes, Gestational / diagnosis*
  • Electroencephalography* / methods
  • Female
  • Gestational Age
  • Glycated Hemoglobin / metabolism
  • Humans
  • Infant, Newborn
  • Mothers
  • Pregnancy
  • Statistics as Topic
  • Term Birth
  • Video Recording / statistics & numerical data

Substances

  • Blood Glucose
  • Glycated Hemoglobin A
  • hemoglobin A1c protein, human