Fetal brain development in diabetic pregnancies and normal controls

Objective:

To compare fetal brain structures assessed in routine sonographic scans during the second and third trimester in diabetic and normal pregnancies.

Materials and methods:

In this retrospective study we measured the head circumference (HC), the transversal diameter of the cerebellum (TCD) and the sizes of the cisterna magna (CM), the cavum septi pellucidi (CSP) and the lateral ventricles (LV) in stored sonographic scans between 20 and 41 weeks of gestation. We compared 231 fetuses of diabetic mothers (diabetic group) to 231 fetuses of normal pregnancies (control group) matched by gestational age. The diabetic group was divided into three subgroups: pre-existing maternal diabetes, diet-controlled gestational diabetes and insulin-dependent gestational diabetes.

Results:

The mean widths of the CSP and LV were larger in fetuses of diabetic mothers in comparison with the controls (P < 0.001, P < 0.001; respectively). The sizes of HC, CM and TCD were similar in both groups. These results were consistent across the three subgroups.

Conclusion:

Diabetes is associated with altered fetal brain development. We would like to introduce the increased widths of CSP and LV as potential markers for gestational diabetes.