Arm movement analysis before and after birth: A comparison of non-diabetic and diabetic pregnancies.

Abstract

Diabetes during pregnancy may affect the motor development of fetuses before and after birth potentially causing changes to their movement patterns. This study explored arm movement variables before and after birth in fetuses and infants of non-diabetic and diabetic mothers. We used a unique measurement method to analyze arm movements looking at the count, range, velocities and duration. In study one we observed fetuses at 28, 32, and 36 weeks of gestation using ultrasound observations. Before birth fetuses of diabetic mothers had larger estimated fetal weight (EFW), larger amniotic fluid index especially at 32 weeks of gestation, and similar 'uterine space' as compared to fetuses of non-diabetic mothers. We observed a recurring group by age interaction pattern where fetuses of diabetic mothers increased the range and average velocity of their arm movements between 32 and 36 weeks of gestation while fetuses of non-diabetic mothers decreased. We would like to suggest a possible connection between the increased amniotic fluid index at 32 weeks of gestation and movement variables (range and average velocity) that requires future exploration. In study two we observed infants at 1, 4, and 8 weeks of age using two infant seat positions (30° & 70° from horizontal) that provided a gravitational manipulation for performing arm movements. After birth infants of diabetic mothers had lower count and smaller range of their arm movements as compared to infants of non-diabetic mothers. The 30° seat position seemed to be a 'higher demand' position for infants to move their arms as compared to the 70° seat position while the 70° seat position was a more sensitive seat position to detect group differences. These results indicate that before birth there were no quantitative differences while after birth there were quantitative and qualitative differences of arm movements. We would like to suggest the lingering effects of the diabetic environment as well as the increased gravitational demands to the system in the form of seat position. These results and our method require further exploration including multiple glucose measurements and long term follow up during the first years of life.