Article
作者: Khurshid, Faiza ; Cieslak, Zenon ; Reichert, Amber ; Strueby, Lannae ; Barrington, Keith ; St-Hilaire, Marie ; Ricci, M. Florencia ; Lee, Kyong-Soon ; Moddemann, Diane ; Kanungo, Jaideep ; Zwicker, Jill ; Sherlock, Rebecca ; Shah, Prakesh S. ; Ng, Eugene ; Emberley, Julie ; Lapoint, Anie ; Bizgu, Victoria ; Beltempo, Marc ; Moodley, Anitha ; Canning, Roderick ; Afifi, Jehier ; Mandel, Ruth ; Coughlin, Kevin ; Fajardo, Carlos ; Banihani, Rudaina ; Church, Paige ; Lee, Shoo K. ; Monterrosa, Luis ; Hendson, Leonora ; Kelly, Edmond ; Mehrem, Ayman Abou ; Morin, Alyssa ; Akinseye, Adetokunbo ; Piedboeuf, Bruno ; Mukerji, Amit ; Drolet, Christine ; Seshia, Mary ; Makary, Hala ; Daboval, Thierry ; Ricci, Florencia ; de Cabo, Cecilia ; Hicks, Matthew ; Nguyen, Kim-Anh ; Lemyre, Brigitte ; Stavel, Miroslav ; McKnight, Sarah ; Ojah, Cecil ; Aziz, Khalid ; Alvaro, Ruben ; Augustine, Sajit ; Pillay, Thevanisha ; Belanger, Sylvie ; Pylypjuk, Christy ; Synnes, Anne ; Da Silva, Orlando ; Wang, Dianna ; strueby, Lannae ; Ting, Joseph ; Louis, Deepak ; Bodani, Jaya ; Ly, Linh ; Toye, Jennifer ; Kajetanowicz, Andrzej ; Claveau, Martine
OBJECTIVETo compare the neurodevelopmental outcomes of infants born at <29 weeks' gestation and exposed to diabetes in pregnancy with those unexposed.STUDY DESIGNThis was a retrospective cohort study using the Canadian Neonatal Network and Canadian Neonatal Follow-Up Network databases. Infants born <29 weeks' gestation and admitted to a level 3 neonatal intensive care unit from 2009 through 2018 who had neurodevelopmental assessments at 18-24 months corrected age were eligible. The 2 primary outcomes were as follows: (1) Neurodevelopmental impairment (NDI) (≥1 of Bayley-III scores < 85 in any domain, cerebral palsy, or vision or hearing impairment); and (2) significant NDI (sNDI) (≥1 of Bayley-III scores < 70 in any domain, cerebral palsy Gross Motor Function Classification System ≥ 3, bilateral blindness, or need for hearing aids or cochlear implants). Secondary outcomes were the individual components of NDI and sNDI. Adjusted odds ratios with 95% CIs were calculated to determine outcomes between groups.RESULTSOf 13 988 eligible infants, 55% attended neurodevelopmental follow-up assessments. Infants exposed to diabetes had increased odds of NDI compared with those unexposed (aOR 1.09 (95% CI 1.08-1.54); there was no difference in sNDI (aOR 1.07 (95% CI 0.84-1.36). Language and motor delays were more common in those exposed to maternal diabetes.CONCLUSIONSHigher rates of NDI, language, or motor delays were present in infants born at <29 weeks' gestation exposed to diabetes in utero. Future research is needed to determine the etiology and clinical significance of these findings.