603 - Comparing Neurodevelopmental Outcomes in Premature Very Low Birth Weight Infants Born to Mothers With and Without Diabetes

Publication Number: 603.4166

Tammy Tran, MUSC Children's Hospital, Charleston, SC, United States; Jill C.. Newman, Medical University of South Carolina College of Medicine, Mount Pleasant, SC, United States; David A. Rueff, Medical University of South Carolina College of Medicine, Charleston, SC, United States; Katherine E. Chetta, Medical University of South Carolina, Charleston, SC, United States; Amy L. Ruddy-Humphries, MUSC, CHARLESTON, SC, United States; Lakshmi D. Katikaneni, MUSC Children's Hospital, Charleston, SC, United States; Laura E. Lach, Medical University of South Carolina College of Medicine, Charleston, SC, United States

Background: Term infants of diabetic mothers (IDMs) have an increased risk of poor neurodevelopmental outcomes (NDO), particularly when hyperglycemia is not well controlled. The neurodevelopmental outcomes of very low birth weight (VLBW) IDMs as compared to their non-IDM counterparts are unknown.

Objective: We aimed to evaluate neurodevelopmental outcomes of premature VLBW IDMs ( < 32 weeks gestation and < 1500g) compared to a control population. We hypothesized that neurodevelopmental testing scores will differ between the two groups.

Design/Methods: A cohort of case-matched VLBW preterm infants admitted to Medical University of South Carolina’s NICU were followed at an outpatient high-risk clinic from 2015 to 2020. Anthropometric data was obtained upon admission and discharge from the NICU. Outpatient neurodevelopmental testing was performed using Capute Scales CAT/CLAMS, Peabody gross motor testing, and Ages & Stages Questionnaires. Capute Scales and Peabody scores were reported as a developmental quotient, while Ages & Stages Questionnaires were scored based on adjusted age cutoff values. Data from the 18-24 month adjusted age visit was prioritized; if unavailable, the closest visit < 24 months adjusted age was used. Clinical variables and neurodevelopmental outcomes were compared between groups using the Chi-Square test, Student’s T-test, Wilcoxon Rank Sum Test, and Fisher’s Exact Test via SAS with significance p < 0.05.

Results: A total of 222 infants were included with 73 IDMs and 149 controls matched on gestational age, sex, and birth weight. The average gestational age was 28.0±2.3 weeks, and the average birth weight was 1040±277 grams. The VLBW IDM cohort had significantly higher proportions of maternal hypertensive disorder and advanced maternal age. Infants in the control cohort had significantly higher rates of maternal substance use. Compared to the control population, VLBW IDMs had lower birth weight and length percentiles, lower birth length z-scores, higher rates of congenital heart disease, and higher rates of genetic anomalies. Our data showed no significant difference between adjusted age neurodevelopmental testing, including cognitive scores (CAT), linguistic/auditory scores (CLAMS), gross motor testing (Peabody), or ages and stages questionnaires for communication, gross motor, fine motor, problem-solving, and personal-social skills.

Conclusion(s): We found no significant differences in NDO between preterm VLBW IDMs and the control population. Additional research is needed to determine what factors in the IDM population are related to NDO and how prematurity influences this relationship.

Demographic and Characteristic Results
Demographic data and characteristics for infants born to mothers with and without diabetes.

Neurodevelopmental Test Results
Results from neurodevelopmental tests (Capute [CAT/CLAMS], Peabody gross motor) and parental questionnaires (Ages & Stages Questionnaire).