In preliminary studies we have developed two non-invasive methodologies for studying the developing brain of the fetus in utero. The first technique is observation of fetal activity cycles. These cycles are defined by fetal cardiac and fetal movement variables. The second technique includes studies of the rhythmic patterns of fetal movement alone, but is based on a different observation time span. Both sets of variables are controlled by the fetal central nervous system and are influenced by signals from the maternal environment, such as sound, movement or elevated blood glucose. In this study both techniques are referred to as activity cycles, although it should be noted that each set of observations in the fetus are measured in different time domains. The first set of observations are completed in the neonatal period. In pilot studies of diabetic mothers who were studied between 30 and 40 weeks of gestation, we documented a different fetal activity cycling when these cycles were compared with observations in non-diabetic mothers. Our purpose in this study is to (1) confirm this initial observation that fetal activity cycling in mothers with diabetes differs from that of the non-diabetic; (2) compare the continuous insulin infusion diabetic patient (insulin pump) with the intermittent insulin controlled diabetic mother in order to see if improvement in glucose control changes this outcome and (3) observe whether the change in activity cycles persists into the neonatal period. The short term metabolic control of the mother will be documented by blood sugar observations on the day of the study and for the previous 24 hours. The longer term control of the diabetes will be documented with the use of glycosylated hemoglobin studies taken each four weeks.
| Robertson, S S (1988) Infants of diabetic mothers: late normalization of fetal cyclic motility persists after birth. Dev Psychobiol 21:477-90 |
| Edelberg, S C; Dierker, L; Kalhan, S et al. (1987) Decreased fetal movements with sustained maternal hyperglycemia using the glucose clamp technique. Am J Obstet Gynecol 156:1101-5 |
| Robertson, S S; Dierker, L J (1986) The development of cyclic motility in fetuses of diabetic mothers. Dev Psychobiol 19:223-34 |
