GROWTH AND MOTOR DEVELOPMENT IN FETUSES OF WOMEN WITH TYPE-1 DIABETES .2. EMERGENCE OF SPECIFIC MOVEMENT PATTERNS

In 20 women with type-1 diabetes, the emergence of fetal movement patterns was studied using real-time ultrasound. One-hour recordings were made once a week between the 7th and 17th week of gestation. Data were compared to those obtained in uncomplicated pregnancy. The diabetic women were being treated with continuous subcutaneous insulin infusion (CSII) therapy. Except for breathing movements, there was a 1-2 week delay in the first appearance of all movement patterns which normally emerge during the first 12 weeks of pregnancy. Breathing movements were observed for the first time at an earlier age than in the control fetuses (P < 0.02). When the emergence of frequently occurring movement patterns was plotted against fetal crown-rump length, which is usually smaller in diabetic pregnancy, there was still a general delay in comparison with the control group. The delay in motor development therefore does not run completely parallel with the delay in growth. This indicates the possible existence of a specific diabetes-related influence on the functional development of the embryonic and fetal nervous system. Hyperglycaemia, for example, may be responsible, as the delay in the emergence of fetal general movements was most profound in the women whose periconceptional quality of glucose control was poor.