orals Australasian Diabetes in Pregnancy Annual Scientific Meeting 2013

Metformin in Gestational diabetes: The Offspring Follow-Up. Cognitive functioning, motor competence and behaviour in the offspring at 6-7 years. (#16)

Suzette M Coat 1 , Rachel S Hughes 1 , William M Hague 1
  1. Robinson Institute, The University of Adelaide, NORTH ADELAIDE, SA, Australia

Background: The Metformin in Gestational diabetes (MiG) trial showed that, in women with gestational diabetes (GDM),metformin was as safe and effective as insulin for both the fetus and the mother during pregnancy and at the time of delivery (1). However, as metformin is known to cross the placenta, it is important to examine the ongoing development of the offspring.

Follow-up studies of the MiG study offspring in Adelaide, Australia and Auckland, New Zealand were conducted at 2-3 years. Both independently found that cognitive and psychomotor performance of the offspring was similar, regardless of GDM treatment received by the mother (2, 3).

Method: MiG trial mothers and their offspring were invited to participate in MiG -The Offspring Follow-Up at 6-7 years (MIG-TOFU 6-7) study in Adelaide. 90 mother-child pairs participated in this follow-up study, which included assessment of growth, as well as assessment of cognitive functioning, motor competence and behaviour in the offspring. Cognitive functioning was assessed using the Weschler Intelligence Scale for Children Fourth Edition (WISC-IV). Motor competence was assessed using the Movement-ABC Second Edition (M-ABC-2) and behaviour was assessed using the Conners Parent Rating Scale-Revised (CPRS-R).

Results: This study is ongoing. To date 90 mother-child pairs have been assessed. Preliminary findings show that cognitive functioning (Full Scale IQ: insulin arm: 107.1, SD 8.49, metformin arm: 106.2, SD 10.78), motor competence (Total Test Score: insulin arm: 54.3, SD 28.37, metformin arm: 54.2, SD 24.12) and behaviour (Conners Global Index Total: insulin arm: 51.2, SD 7.97, metformin arm: 52.3, SD 11.23; DSM-IV Total (insulin arm: 51.6, SD 7.13, metformin arm: 52.4, SD 11.27) of the children are similar regardless of treatment the mother received for her gestational diabetes.

Conclusions: In this small cohort of the MiG offspring we assessed cognitive functioning, motor competence and behaviour. It is reassuring that the children whose mothers received metformin for treatment of GDM continue to have similar intellectual, gross and fine motor and behavioural outcomes when compared with children whose mothers received insulin.

  1. Rowan et al., N Engl J Med 2008;358:2003-15.
  2. Coat et al, poster presentation at Australian Diabetes in Pregnancy Society Annual Scientific Meeting, November 2011.
  3. Battin et al, oral presentation at Perinatal Society of Australia and New Zealand Annual Congress, April 2013.