Effect of Maternal Diabetes on Brain Development, as Measured by Neonatal Electroencephalogram (EEG)

Summary

Alterations in the intrauterine environment can have profound effects on fetal development. Diabetes during gestation results in multiple deleterious short-term outcome differences, and is correlated with long-term developmental deficits. Multiple studies, in neonates through school-aged children, have demonstrated differences in language, attention and psychomotor development in offspring of diabetic pregnancies. Neonatal EEG is a promising and non-invasive tool for assessment of abnormal brain development or "dysmaturity" in this population. Multiple conventional EEG (cEEG) and amplitude-integrated EEG (aEEG) parameters change predictably with advancing gestational development and have been used to differentiate between at risk groups in neonatal studies.

The investigators hypothesize that neonatal EEG can identify brain dysmaturity in infants of diabetic mothers (IDMs) compared to gestational-age matched controls. The primary aim is documentation of brain dysmaturity in IDMs using cEEG. The secondary aim is establishment of aEEG as a more accessible tool to quantify the effects of maternal diabetes on neonatal brain development.

The investigators will conduct a pilot study comparing cEEG and aEEG parameters of cases to gestational-age matched controls. Cases will be IDM neonates of at least 35 weeks' gestation whose mothers were recommended treatment with either insulin or an oral glycemic agent. Video EEG recording will be planned for approximately 60 minutes and obtained between 24 hours and 5 days of life during birth hospitalization. Additional data will be extracted from maternal and neonatal medical records and a maternal questionnaire.

In addition to evaluating the measures of cEEG and aEEG, this project will establish a research cohort. A subsequent study involving developmental evaluations will allow for correlation of EEG results with long-term outcomes. The ability to identify those at risk at birth would provide the opportunity to intervene in order to mitigate outcome differences, particularly in language development. More significantly, we hope to establish neonatal CNS outcome measures for future diabetic pregnancy intervention studies. .

Conditions

• Diabetes in Pregnancy
• Diabetes, Gestational
• Infant, Newborn, Diseases
• Perinatal Disorders of Growth and Development

Interventions

OTHER

Video Electroencephalogram (EEG)

Single neonatal video EEG at 24 hrs to 5 days of life during birth hospitalization. Neonatal scalp leads, respiratory and nasal leads. Approximately 60 minute recording.

OTHER

Point-of Care Blood Sugar Testing

One-time heel-stick point-of-care blood sugar testing at time of EEG.

OTHER

Medical Record Data Extraction

Medical record data extraction from both maternal obstetric and neonatal medical record for variables known to impact EEG and neurodevelopmental outcomes.

OTHER

Maternal Questionnaire

One-time maternal questionnaire related to smoking practices, ETOH consumption, level of education, and body mass index.

Sponsors & Collaborators

• University of Rochester

  lead OTHER

Principal Investigators

• Laura M Price, MD · University of Rochester

• Ronnie Guillet, MD, PhD · University of Rochester

Eligibility

Min Age

24 Hours

Max Age

120 Hours

Sex

ALL

Healthy Volunteers

Yes

Timeline & Regulatory

Start

2016-09-01

Primary Completion

2018-10-01

Completion

2018-10-01

Countries

• United States

Study Locations