Hyperglycemia in pregnancy and neurodevelopmental scores in infants and children using ages and stages questionnaires
Date of Award
Master of Science in Epidemiology & Biostatistics (MSc Epidemiology & Biostats)
Community Health Sciences
Hyperglycemia in pregnancy (HIP) is considered as high-risk because fetal and neonatal complications and congenital malformations are directly related to poor glycemic control throughout pregnancy. HIP may lead to programming of certain brain loci and altered neurodevelopment. Neurodevelopmental outcomes are closely linked to the developing brain and can be assessed in early years of live using different assessment tools. We assessed association between HIP and neurodevelopmental scores of infants and children using Ages and Stages Questionnaires. Methods: Exposure to HIP was determined from antenatal records of the Aga Khan Hospital Karachi. Neurodevelopmental assessment of 155 children aged 4 to 36 months was performed in 5 domains (Communication, Gross Motor, Fine Motor, Problem Solving, and Personal-Social) using Ages & Stages Questionnaire and overall health assessment by using Multiple Indicator Cluster Surveys Questionnaire. Results: In HIP group (n=72), aggregate neurodevelopmental scores were significantly lower 212.63 (SD=41.23) compared to in Non-HIP group [237.77 (SD=42.34) (p value <0.001)]. Their other impaired domains were gross motor (p value <0.001), personal social (p value <0.001), and communication (p value 0.019). After adjustment for relevant maternal/child factors and stimulation and learning opportunities which were available to the child, HIP was associated with altered aggregate neurodevelopmental (/3 coeff —22.83, 95% CI: -39.40 , - 6.26), communication (/3-coeff -3.93, 95% CI: -8.12 , 0.25, gross motor (/3-coeff -6.86, 95% CI: -11.24 , -2.48), and personal social (/3-coeff 8.74, 95% CI: -13.08 , -4.39) domains. Conclusion: HIP is associated with altered neurodevelopment in infants and children independent of maternal and child characteristics. We recommend that children born to HIP mothers should undergo routine neurodevelopmental assessment during preschool age. Key Words: Hyperglycemia in pregnancy, Ages & Stages Questionnaire, Neurodevelopmental scores
Aziz, H. (2017). Hyperglycemia in pregnancy and neurodevelopmental scores in infants and children using ages and stages questionnaires (Unpublished doctoral thesis). Aga Khan University, Karachi, Pakistan.