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Gestational diabetes slows fetal postprandial brain response
The fetuses of women with gestational diabetes react more slowly to auditory stimulation of their brain than those of women with normal glucose tolerance, according to research in The Journal of Clinical Endocrinology & Metabolism.
“This is the first time a study has shown that the mother’s gestational diabetes can affect how quickly her fetus reacts to stimuli after a meal,” Hubert Preissl, PhD, of the University Hospital Tübingen, German Center for Diabetes Research, and the Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Germany, said in a press release. “The findings provide important insights into how the mother’s gestational diabetes diagnosis can affect her child’s brain activity.”
Preissl and Katarzyna Linder, MD, of the University Hospital Tubingen, and colleagues analyzed data from 12 pregnant women with gestational diabetes and 28 pregnant women who had normal glucose tolerance. Within the cohort, gestational age ranged from 27 to 36 weeks (mean gestational age, 30.3 weeks); all pregnancies were uncomplicated and singleton. All women underwent a 75-g oral glucose tolerance test. Researchers measured fetal auditory evoked response latencies to a 500-Hz tone (duration, 500 ms; intensity, 95 dB). Blood was drawn from participants before the OGTT and after 60 and 120 minutes; each blood extraction was preceded by fetal magnetoencephalography (fMEG) measurements. Fetal head position was determined via ultrasound before the first and after the last fMEG measurement.
Researchers found that between 0 and 60 minutes, latencies decreased from a mean of 260 ms to 206 ms (P = .008) in the fetuses of women with normal glucose tolerance, and they remained stable until 120 minutes (P = .129). There was no change in response latencies in the fetuses of women with gestational diabetes during the OGTT (P = .11).
Fetal latencies in the gestational diabetes group were longer than in the control group at 60 minutes after glucose ingestion (296 ms vs. 206 ms; P = .001). Linear regression models showed maternal glucose, insulin levels and insulin sensitivity were associated with response latencies 60 minutes after glucose ingestion.
The results echo similar findings by Linder and colleagues that assessed a link between fetal brain response and maternal insulin resistance in healthy pregnant women.
“One explanation for this finding could be that higher glucose levels hamper the action of high insulin levels on improving brain function of the fetus,” the researchers wrote. “Another mechanistic explanation could be that, in the [gestational diabetes] fetus with permanent hyperinsulinemia, peripheral as well as central desensitization induce the functional effect of prolonged fetal [auditory evoked response] latency.” – by Regina Schaffer
Disclosure: The researchers report no relevant financial disclosures.