Journal on Developmental Disabilities

Abstract

In pregnancy, there is an inevitable sharing of maternal nutrients through transport via the placenta. Changes in the maternal system affect the fetal plasma composition and thus the development of fetal organs. Alterations in the fetal environment that affect fetal development have been hypothesized to have consequences in postnatal life. Maternal diabetes, which is associated with high blood glucose levels (hyperglycemia), is one such compromising environment; excess glucose is shunted into the fetal system which then must make adaptations to the altered environment. This results in a variety of fetal, neonatal, and postnatal consequences for the offspring of diabetic mothers including very large size at birth, birth defects, various short-term and long-term complications, and harmful effects on the brain. This review is aimed at summarizing the effects of maternal diabetes on her offspring, with a focus on long-term effects in the brain. Neuropsychological deficits in intelligence and memory, psychomotor development and sensory functions, as well as attention and hyperactivity, have been shown to be associated with maternal diabetes in the literature. However, with tightly controlled blood glucose levels, these outcomes have the potential to be minimal consequences of maternal diabetes. Unfortunately, some segments of the population do not have adequate control of their blood sugar level, and are still exposed to effects of hyperglycemia. One such population is our First Nations people who have experienced epidemic-like increases in type 2 diabetes in the past 20 years. Due to barriers in treatment of this population, they are still at risk for the more severe consequences of uncontrolled diabetes, including those consequences for infants born to diabetic mothers. There has been both a national and an international drive to find solutions to this problem, as well as a critical look into treatments and prevention regimes, for the general population and for Aboriginal populations.

download article >>