Correlations between antepartum maternal metabolism and newborn behavior.

We suggested that antepartum maternal metabolism may affect later cognitive and behavioral function of progeny by impacting on developing brain cells in utero. This study reports on the observed relationships between serial characterizations of maternal fuels during pregnancy and Brazelton neonatal behavioral assessment scale ratings of offspring from 73 well-controlled pregestational diabetic patients, 112 gestational diabetic patients, and 24 nondiabetic patients. After controlling for the effects of premature birth on the Brazelton neonatal behavioral assessment scale, significant correlations were found between second- and third-trimester glycemic regulation (hemoglobin A1c and fasting plasma glucose levels) and three of four newborn behavioral dimensions of the Brazelton neonatal behavioral assessment scale. In each case, as maternal glucose increased, the newborns' Brazelton neonatal behavioral assessment scale responses were poor. Results were not substantially different when gestational and pregestational diabetic patients were analyzed separately, nor can they be attributed to various perinatal events (neonatal asphyxia, hypoglycemia) or differences in socioeconomic status or ethnicity. The presence of fuel-related neurobehavioral deficits in neonates of diabetic mothers suggests that such infants start their interactions with care givers from a modified base.