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Yıl:2019; Cilt: 20; Sayı: 4>> Özet
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Anadolu Psikiyatri Dergisi; 2019;20(4):342-348
Diyabetik gebelerden doğan çocuklarda dikkat eksikliği hiperaktivite bozukluğu ve özgül öğrenme güçlüğü açısından değerlendirilmesi: Olgu kontrol çalışması
İ Akaltun, ÖE Yapça, H Ayaydın, T Kara
Gaziantep Dr. Ersin Arslan Training and Research Hospital, Gaziantep
Riskli hamileliklerden doğan çocuklarda nörogelişimsel bozukluklara eğilimin arttığı bilinmektedir. Çalışma-mızda diyabetik gebelik ile dikkat eksikliği hiperaktivite bozukluğu (DEHB) ve özgül öğrenme güçlüğü (ÖÖG) arasındaki ilişkiyi araştırmayı amaçladık. Yöntem: Bu çalışmaya, annelerinde diyabetik gebeliği olan 137 çocuk ile annesinde diyabetik gebelik öyküsü olmayan 128 çocuk alındı. Olgu gurubunda 49 katılımcının insüline bağımlı diyabetes mellitus (İBDM), 88 katılımcının gestasyonel diyabetes mellitus (GDM) öyküsü vardı. Tüm katılımcılar, Okul Çağı Çocukları için Duygulanım Bozuklukları ve Şizofreni Görüşme Çizelgesi-Şimdi ve Yaşam Boyu Şekli (6-18) (K-SADS PL), Wechsler Çocuklar için Zeka Testi (WISC-R), ÖÖG Bataryası ile değerlendirildi. Elde edilen sonuçlar istatistiksel olarak karşılaştırıldı. Bulgular: Olgu ve kontrol grupları arasında DEHB ve ÖÖG tanısı oranları arasında istatistiksel olarak anlamlı fark vardı. İBDM ve GDM ile kontrol grubu karşılaştırıldığında sözel/performans/ toplam IQ puanları arasında anlamlı fark saptandı. İBDM ve GDM kendi içlerinde karşılaştırıldığında sözel/perfor-mans/toplam IQ puanları arasında anlamlı fark saptanmadı. IDDM ve GDM grupları arasında DEHB ve ÖÖG tanıları arasında anlamlı fark olduğu görüldü. Tüm parametrelerde açlık kan şekeri (AKŞ) arttıkça IQ puanlarında düşüş olduğu görülmüştür Sonuç: Diyabetik gebelerden doğan çocuklarda DEHB ve ÖÖG tanılarının diyabetik olmayan gebelerden doğan çocuklara göre daha fazla olduğu görüldü. Diyabetik gebeliğin ve kan şekeri kontrolünün, bebek-lerin nörogelişimsel bozukluklar üzerine etkisi konusunda daha geniş kapsamlı çalışmalara gerek vardır.
An evaluation of attention deficit hyperactivity disorder and specific learning disorder in children born to diabetic gravidas: a case control study
Children born after risky pregnancies are known to have an increased disposition to neurodevelopmental disorders. The purpose of our study was to investigate the relationship between diabetic pregnancy and attention deficit hyperactivity disorder (ADHD) and specific learning disorder (SLD). Methods: One hundred thirty-seven children of mothers with diabetic pregnancies and 128 children of mothers without a history of diabetic pregnancy were enrolled. Forty-nine of the case group had a history of insulin-dependent diabetes mellitus (IDDM) and 88 of gestational diabetes mellitus (GDM). All participants were evaluated using The Kiddie Schedule for Affective Disor-ders and Schizophrenia for School-Age Children (6-18) (K-SADS PL), the Wechsler Intelligence Scale for Children-Revised (WISC-R), and the SLD Battery. The results were then subjected to statistical analysis. Results: A statisti-cally significant difference was determined between the case and control groups in terms of levels of diagnosis of ADHD and SLD. Significant differences were determined between verbal/performance/total IQ scores when IDDM and GDM were compared with the control group. When the IDDM and GDM subgroups were compared among themselves, no significant difference was determined between verbal/performance/total IQ scores. Significant varia-tion was observed between the IDDM and GDM groups in terms of ADHD and SLD diagnoses. IQ scores decreased as fasting blood sugar increased in all parameters. Conclusion: Significantly, more diagnoses of ADHD and SLD were observed in children born to diabetic mothers compared to those of non-diabetic mothers. Further, wide-ranging studies on the subject of the effect of diabetic pregnancy and blood sugar control on infant neurodevel-opmental disorders are now needed.

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