Retardation of CNS Development in Newborns after Gestational Diabetes Mellitus

Background: Infants from mothers with gestational diabetes mellitus (GDM) have disadvantageous not only postnatal adaptation but sequences such as neurology disturbances and obesity.

Objective: To asses clinical and objective evidence retardation of CNS development in full term newborns from mothers with GDM.

Methods: Clinical and laboratory investigations with neurosonographic and electropoligraphic characteristics of the cycle organization of sleep were performed in 83 macrosomia newborns which are born to mothers with GDM and 63 normal full term neonates (control group). Neuron specific enolase (NSE), Brain derivate neuron factor (BDNF), Melatonin in nocturnal blood and serotonin in rich platelet’s plasma on 3 day of life were determined. 105

Results: Changes of brain structure (cysts of vessels plexuses, asymmetry of side ventricles of the brain, broadening of brain liquor space) and cerebral ischemia were revealed in 18,4% newborns from mothers with GDM. NSE in twice higher (32,43±3,72 мкг/л and norm 17,15 ±2,1 мкг/л 5 , Р<0,01), but BDNF (299,10 ±33,92 pg/ml and 628,51 ±70,39 pg/ml, Р<0,05), serotonin (299,10 ±33,92 mmol/l and 628,51 ±70,39 mmol/l, Р<0,05) and melatonin (5,2±1,2 ng/ml and 11,6±1,7 ng/ml, Р<0,05 respectively) in twice low in newborn tо mother with GDM. It combined with non-differentiated state in the sleep structure and the arrested development of tonic and reflection reactions. Retardation of psychomotor development took place by the end of the first year of life. One of the main sources of these trouble is low production of melatonin which is served from serotonin not only in epiphysis but in others tissues especially in the brain. 136

Conclusion: The precautionary measures for prevent disadvantageous sequences of GDM:
the early diagnosis GDM and comprehensive care. Successful management of infants of diabetic mothers is based on early recognition of CNS disorders with clinical and biochemical markers. MT as neurotransmitter and endogenous antioxidant may potentially be useful for the restore development CNS function.