Abstract: Objective To investigate the physical and neuropsychological development of the offspring born to mothers with gestational diabetes mellitus (GDM) at 2 years of age, and to provide evidence to enhance the physical and neuropsychological development of GDM offspring. Methods A retrospective analysis was conducted on neonates born in the Department of Obstetrics at Qinzhou Maternal and Child Health Hospital from January 2018 to December 2018 and regularly followed at the outpatient service. The neonates were categorized into two groups based on whether their mothers were diagnosed with GDM during pregnancy:the GDM group (n=243) and the control group (n=362). The general clinical data, follow-up information on physical development and neuropsychological development at 1 year and 2 years of age for all children were collected. Their height, head circumference, body weight, BMI, and Gesell developmental quotients (DQs) at 1 year and 2 years of age for both groups were analyzed. Results 1) There were no significant differences in height, head circumference, body weight, and body mass index (BMI) between the two groups at 1 year and 2 years of age during the follow-up period (P＞0.05). 2) At 1 year of age, the GDM group exhibited higher rates of abnormal language development (8.6% vs. 3.3%, χ²=7.854), adaptive behavior(11.4% vs. 5.0%, χ²=8.605), and personal social behavior(8.2% vs. 3.0%, χ²=8.062) compared to the control group (P<0.05), and lower DQs for these Gesell subscales (language development 87.6±7.7 vs. 89.4±9.2, t=2.591; adaptive behavior:88.4±7.8 vs. 90.5±8.9, t=2.957; personal social behavior:89.1±7.0 vs. 91.2±7.5, t=3.495, P＜0.05). 3) At 2 year of age, the GDM group also showed higher rates of adaptive behavior (8.2% vs. 4.1%, χ²=3.927) and personal social behavior (7.3% vs. 3.0%, χ²=4.093) compared to the control group (P<0.05), and lower DQs for these Gesell subscales (adaptive behavior:89.5±6.5 vs. 91.9±6.9, t=3.878; personal social behavior:89.9±7.1 vs. 92.1±6.9, t=3.311, P＜0.05). Conclusions The development of adaptive behavior and personal social behavior in offspring born to mothers with GDM remains delayed. Follow-up for GDM offspring should prioritize achieving a balanced development of adaptive behavior and personal social behavior.

Key words: gestational diabetes mellitus, physical growth, neuropsychological development, Gesell Developmental Scale

摘要： 目的 了解妊娠期糖尿病(GDM)子代2岁体格生长与神经心理发育情况,为改善GDM母亲子代的体格与神经心理发育提供依据。方法 选取2018年1—12月在钦州市妇幼保健院分娩的且出院后定期随访、资料完整的新生儿为研究对象,根据其母孕期是否诊断GDM分为GDM组(n=243)和对照组(n=362),收集所有研究对象的一般资料、随访至1岁、2岁时体格与神经心理发育的指标,比较两组1岁、2岁时体格与神经心理发育的差异。结果 1)随访至1岁、2岁时,两组儿童的身高、体重、头围、体质量指数(BMI)比较,差异均无统计学意义(P＞0.05)。2)随访至1岁时Gesell量表结果:GDM组语言(8.6%)、适应性(11.4%)、个人社交(8.2%)异常的发生率均较对照组(3.3%、5.0%、3.0%)高(χ²=7.854、8.605、8.062,P＜0.05),相对应的DQ值[(87.6±7.7)分、(88.4±7.8)分、(89.1±7.0)分]较对照组[(89.4±9.2)分、(90.5±8.9)分、(91.2±7.5)分] 低(t=2.591、2.957、3.495,P＜0.05)。3)随访至2岁时Gesell量表结果:GDM组适应性(8.2%)和个人社交(7.3%)异常的发生率较对照组(4.1%、3.0%)高(χ²=3.927、4.903,P＜0.05),相对应的DQ值[(89.5±6.5)分、(89.9±7.1)分]较对照组[(91.9±6.9)分、(92.1±6.9)分] 低(t=3.878、3.311,P＜0.05)。结论 GDM子代的个人社交和适应性的发育水平整体落后于正常儿童,GDM子代的随访应重视个人社交和适应性的平衡发展。

关键词: 妊娠期糖尿病, 体格生长, 神经心理发育, Gesell发育量表