1345-P: Long-Term Follow-Up of Children with Intrauterine Glyburide Exposure

Outcome data in children exposed to glyburide for maternal treatment of gestational diabetes mellitus (GDM) is lacking. Insulin is the standard of care for GDM medical management, yet glyburide use is increasing and this medication crosses the placenta. The study objective was to evaluate physical and neurodevelopmental outcomes of 5-10 year old children born to GDM mothers treated with glyburide or insulin. Children had anthropometric measures including body composition with air displacement plethysmography, and underwent a neurodevelopmental assessment with performance-based tests to evaluate executive functions of working memory and inhibition. Analysis included paired t-tests, chi-square test, and multivariate analysis of variance (MANOVA). Participants, n=51, 25 glyburide-exposed, 26 insulin-exposed were age and sex-matched between groups. Mean age was 7.7 years and 45% were female. Ethnicity and maternal education differed between groups: glyburide-exposed were primarily Hispanic (80%) and had lower maternal education level compared to insulin-exposed (50% Hispanic). Anthropometric means were: BMI 18.8 kg/m² (sd 5.1), BMI%ile 67.7% (32.3), waist circumference z-score 0.6 (1.1), body fat 21.9% (11.6), triceps z-score 0.8 (1.2), subscapular z-score 1.1 (1.1), sum of 3 skinfolds, triceps, subscapular, iliac crest 39.3 mm (26.0), systolic bp 101 (10.1), diastolic bp 63 (8.2). Among participants, 17.6% had an overweight BMI and 23.5% had an obese BMI. No significant differences were identified in these measures or rates of overweight/obese BMI between groups. A MANOVA with maternal education as a covariate showed that the glyburide-exposed group had significantly lower scores on a visual-spatial working memory test compared to the insulin-exposed group (p=0.03). No differences were observed on an inhibition test.

In summary, children with intrauterine glyburide exposure had reduced spatial working memory yet similar physical measurements compared to children with insulin exposure.