INTRODUCTION There are data linking gestational diabetes mellitus (GDM) with adverse neurodevelopmental outcome in the offspring. We investigated the effect of GDM on microstructural brain development and neurodevelopmental outcome of very preterm infants. MATERIALS AND METHODS Preterm infants <32 gestational weeks of mothers with GDM obtained cerebral magnetic resonance imaging (MRI) including diffusion-tensor imaging at term-equivalent age. For every infant, two gestational age-, sex-, and MRI scanner type-matched controls were included. Brain injury was assessed and fractional anisotropy (FA) and apparent diffusion coefficient (ADC) measured in 14 defined cerebral regions. Neurodevelopmental outcome was quantified at the corrected age of 24 months using the Bayley Scales of Infant Development. RESULTS We included 47 infants of mothers with GDM and 94 controls. There were no differences in neonatal morbidity between the groups, nor in any type of brain injury. The GDM group showed significantly higher FA values in the centrum semiovale, the posterior limb of the internal capsule and the pons bilaterally, in the corpus callosum and the right occipital white matter, as well as lower ADC values in the right centrum semiovale, the right occipital white matter and the corpus callosum. Neurodevelopmental outcome did not differ between the groups. CONCLUSION We found no impairment of brain development in GDM-exposed infants compared to matched controls, but differences in white matter microstructure in specific regions indicating an enhanced maturation. However, neurodevelopmental outcome was equal in both groups. Further studies are needed to better understand brain maturation in preterm infants exposed to GDM.

中文翻译：

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患有妊娠糖尿病的母亲所生的极早产儿的微结构大脑发育和神经发育结果。

简介 有数据表明妊娠期糖尿病 (GDM) 与后代神经发育不良结果有关。我们研究了 GDM 对极早产儿大脑微观结构发育和神经发育结果的影响。材料和方法 患有 GDM 的母亲的孕周 < 32 周的早产儿在足月当量年龄获得了脑磁共振成像 (MRI)，包括弥散张量成像。对于每个婴儿，包括两个胎龄、性别和 MRI 扫描仪类型匹配的对照。评估了脑损伤，并测量了 14 个定义的大脑区域的分数各向异性 (FA) 和表观扩散系数 (ADC)。使用贝利婴儿发育量表在 24 个月的校正年龄时对神经发育结果进行量化。结果 我们纳入了 47 名患有 GDM 的母亲所生的婴儿和 94 名对照者。各组之间的新生儿发病率以及任何类型的脑损伤均没有差异。GDM组的半卵圆中心、内囊后肢和双侧脑桥、胼胝体和右侧枕叶白质的FA值显着较高，右侧半卵圆中心、右侧枕叶白质的ADC值较低。枕叶白质和胼胝体。各组之间的神经发育结果没有差异。结论 我们发现，与匹配的对照组相比，GDM 暴露的婴儿的大脑发育没有受到损害，但特定区域的白质微观结构存在差异，表明成熟程度有所提高。然而，两组的神经发育结果相同。需要进一步的研究来更好地了解暴露于 GDM 的早产儿的大脑成熟情况。