Early spontaneous movements in full-term infants exposed to gestational diabetes mellitus

Background

Gestational diabetes mellitus (GDM) may influence fetal neurodevelopment, and early motor assessments could help identify at-risk infants before clinical symptoms emerge.

Aim

To examine early spontaneous movements in full-term infants born to mothers with GDM.

Method

Thirty-two full-term infants with prenatal exposure to GDM and 32 age-matched healthy controls were included in this case-control study. After recording maternal and infant demographic and clinical characteristics, video recordings were obtained for General Movements Assessment (GMA) at 52–54 weeks postmenstrual age. Detailed GMA was performed, and the Motor Optimality Score (MOS) was calculated for each infant.

Results

Fidgety movements were observed as normal in both groups. There were no significant differences between the groups in demographic or clinical characteristics, except for birth weight, which was higher in the GDM-exposed group (p = 0.002). After adjusting for gestational age, birth weight, and treatment modality, total MOS scores were significantly lower in the GDM-exposed group (p = 0.038), and the movement character subcategory also remained significantly altered (p = 0.025). No significant associations were found between clinical variables and MOS within the GDM-exposed group.

Conclusion

These findings suggest that intrauterine hyperglycemia may have subtle but measurable effects on early motor development in infants of mothers with GDM. Altered movement character and lower adjusted MOS scores highlight the potential vulnerability of this population, even in the absence of gross motor impairment. Early detection of such changes through GMA may help identify infants who could benefit from close developmental monitoring and timely intervention, thereby supporting better long-term outcomes.