Diabetic Mothers – The Evidence Mounts
Pregnant women who suffer from diabetes are more likely to have a child with memory problems, according to a new study.
The researchers believe the children’s poor memories are the result of inadequate levels of iron and oxygen reaching the brain’s memory centre during its crucial developmental phase. However, they stress that diabetics who properly control their condition during pregnancy avoid risking damage to their child’s memory.
Tracy DeBoer at the University of California in San Diego, US, and colleagues followed a group of mothers beginning early on in their pregnancy. They tested the mothers’ blood sugar and iron levels regularly and the
n followed their infants after birth, carrying out regular blood sugar and iron tests, as well as memory exams that grew more complex as the children aged.
Diabetic mothers who had widely fluctuating blood sugar levels during pregnancy had children who performed worse than children in a control group in a series of memory tests at 12 months of age – and the effects are still significant at age three-and-a-half, says DeBoer.
But the loss in memory performance was only noticeable during the more difficult memory tests, she says, resulting in scores that were one-third poorer than unaffected children. In easier tests, the 20 children of diabetic mothers performed almost as well, or the same, as the 20 children in the control group.
The research was presented last month at a meeting of the American Association for the Advancement of Science in San Francisco, California, US. And, reported in Developmental Medicine and Child Neurology (vol 47, p 525)
Memory centre
Pregnant women who have fluctuating blood glucose levels confer these fluctuations onto their fetuses through the bloodstream, explains DeBoer. One result of this is that available iron reserves in the fetus are conserved to make more haemoglobin. This results in iron shortages in the brain – notably in its memory centre, which is called the hippocampus.
“The hippocampus is very metabolically active, particularly during fetal development, and requires a lot of iron,” DeBoer says. “Iron level in pregnancy was directly related to how well the child did in memory tests at age 3.5 – the greater the iron, the better the memory.”
The long-lasting effects of prenatal hippocampus impairment is very interesting because studies show that the hippocampus is only partly developed at birth, says Patricia Bauer, an infant memory researcher at Duke University in North Carolina, US. “This initial, prenatal laying down of neurons is clearly a critical stage in the development of the hippocampal structures.”
Iron supplements
And electro-physiological tests performed on the toddlers during memory testing also appear to show a reduction in brain activity in the hippocampus in children with diabetic mothers, although it is difficult to locate the source of the brain activity using these EEG tests, DeBoer says.
The ongoing study will follow the children to see if their memory problems persist to school age and beyond, and more accurate functional MRI brain scans will be performed on the older children to determine how active their hippocampal region is when processing and consolidating new memories.
Iron supplements could reduce the risk in some pregnant women, DeBoer suggests. Diabetes affects around 10% of all pregnancies in the US.
Diabetes and Pregnancy
You have the good fortune to live when you do. Health care providers no longer discourage women with diabetes from becoming pregnant.
We now know that the key to a healthy pregnancy for a woman with diabetes is keeping blood glucose (sugar) in the target range — both before she is 
pregnant and during her pregnancy. To do this, you need a diabetes treatment plan that keeps meals, exercise, and insulin in balance.
This plan will change as you change with pregnancy. You will also need to check your blood glucose often and keep a record of your results. With your blood glucose in the target range and good medical care, your chances of a trouble-free pregnancy and a healthy baby are almost as good as they are for a woman without diabetes.
Go for it!
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