Fetal behavior in diabetic and nondiabetic pregnant women: An exploratory study

Abstract

To characterize differential behavior and the relationship between maternal blood glucose levels and behavior in fetuses of diabetic (n = 10) and nondiabetic (n = 20) women at 33 and 36 weeks gestational age (GA), spontaneous changes in fetal heart rate (FHR), body and breathing movements, and vibroacoustic stimulus elicited (3 stimulus/3 no-stimulus control trials) FHR changes and body movements were compared. Measures of maternal blood glucose levels were obtained immediately following testing; measures varied within normal range. Spontaneous behaviors showed no differences between groups and no relationship to maternal blood glucose levels. Sensory stimulation elicited similar average peak FHR accelerations (M = 17. 1/20.0 BPM) and average movement scores (2.0/2.6) across groups. In the diabetic group at 33 weeks GA, the nature of the FHR change over time, showed more varied patterns of response, a shorter latency to peak acceleration, was less organized, and less mature; as average maternal blood glucose levels increased, elicited body movements decreased. These findings suggest immaturity and differential functional development of sensory-motor response systems in fetuses of diabetic mothers.

Auditory Processing in Growth-Restricted Fetuses and Newborns and Later Language Development

“…Fetal response to the mother's or a female stranger's voice was examined. Differential fetal responding to sensory stimuli has been reported in previous studies of low risk, uneventful pregnancies compared to pregnancies complicated by conditions associated with nutritional/oxygen deprivation-for example, studies investigating mother's voice and preeclampsia , mother's voice and hypertension (Lee et al, 2007), vibroacoustic stimulus and hypertension (Warner et al, 2002), vibroacoustic stimulus and diabetes (Allen & Kisilevsky, 1999), mother's voice and diabetes (Kisilevsky et al, 2012), and mother's voice and smoking (Cowperthwaite et al, 2007)-which is the most common cause of growth restriction (Giles et al, 1985;Resnik, 2002;Trudinger et al, 1987).…”

“…Researchers investigating animal models of placental insufficiency have demonstrated subtle deficits in neural conduction, which may have implications for auditory perception (Rees, Proske, & Harding, 1989;Rehn et al, 2002). In addition, differential fetal cardiac responses to auditory probes have been reported in comparisons of low-risk, uneventful, and high-risk pregnancies complicated by conditions associated with nutritional/oxygen deprivation, such as preeclampsia , hypertension (Lee, Brown, Hains, & Kisilevsky, 2007;Warner, Hains, & Kisilevsky, 2002), diabetes (Allen & Kisilevsky, 1999;Kisilevsky, Gilmour, Stutzman, Hains, & Brown, 2012), and smoking (Cowperthwaite, Hains, & Kisilevsky, 2007). Taken together, these findings indicate that fetal auditory-system development may influence subsequent language abilities.…”

Fetal cyclic motor activity in diabetic pregnancies: Sensitivity to maternal blood glucose

“…There is some evidence that fetal behavior is sensitive to concurrent maternal blood glucose levels in diabetic and nondiabetic pregnancies, although the results have been mixed. Some studies have reported increased fetal movement (Aladjem, Feria, Rest, Gull, & O'Connor, 1979;Eller, Stramm, & Newman, 1992;Gelman, Spellacy, Wood, Birk, & Buhi, 1980;Goodman, 1980;Miller, Skiba, & Klapholz, 1978;Richardson, Briggs, Toomey, Burry, & O'Grady, 1983), some have reported decreased fetal movement (Allen & Kisilevsky, 1999;Devoe, Searle, Castillo, & Searle, 1987;Edelberg, Dierker, Kalhan, & Rosen, 1987;Holden, Jovanovic, Druzin, & Peterson, 1984), and others have reported no effects (Bocking, 1989;Bocking, Adamson, Carmichael, Patrick, & Probert, 1984;Bocking et al, 1982;Lewis, Trudinger, & Mangez, 1978;Natale, Patrick, & Richardson, 1978;Natale, Richardson, & Patrick, 1983;Patrick, Campbell, Carmichael, Natale, & Richardson, 1982;Reece et al, 1995;Wladimiroff & Roodenburg, 1982) of elevated maternal blood glucose. However, the previously reported effects of maternal diabetes on fetal CM (Robertson & Dierker, 1986) were accounted for by a subgroup of fetuses whose mothers' blood glucose was least well controlled.…”

Atypical Fetal Response to the Mother's Voice in Diabetic Compared With Overweight Pregnancies

“…Consistent with previous work demonstrating that fetuses of diabetic mothers display immature behaviors 1,2,17 and a less organized, less mature heart rate change to a vibroacoustic stimulus, 3 it could be that the atypical fetal response to the mother's voice represents immature neurological development or immature development of the auditory system. The results of studies of primitive learning provide some support for this postulate.…”

“…19 In response to a vibroacoustic stimulus (a multimodal stimulus delivered on the maternal abdomen including both sound and a mechanical vibration), fetuses of diabetic women are reported to take longer to habituate (i.e., decrease responding to a repeatedly presented stimulus 4 ) and habituate less often. 5 Furthermore, at 33 weeks, 3 an increased latency to peak acceleration and a less organized, less mature heart rate response has been reported; as average maternal blood glucose levels increased, elicited body movements decreased. These findings also suggest immaturity and differential functional development of sensory-motor response systems in fetuses of diabetic mothers.…”