title: Brain Development in Fetuses of Mothers with Diabetes: A Case-Control MR Imaging Study.
abstract: OBJECTIVE
  Offspring exposed to maternal diabetes are at increased risk of neurocognitive impairment, but its origins are unknown. With MR imaging, we investigated the feasibility of comprehensive assessment of brain metabolism (1H-MRS), microstructure (DWI), and macrostructure (structural MRI) in third-trimester fetuses in women with diabetes and determined normal ranges for the MR imaging parameters measured.
  
  
  METHODS
  Women with singleton pregnancies with diabetes (n= 26) and healthy controls (n= 26) were recruited prospectively for MR imaging studies between 34 and 38 weeks' gestation.
  
  
  RESULTS
  Data suitable for postprocessing were obtained from 79%, 71%, and 46% of women for1H-MRS, DWI, and structural MRI, respectively. There was no difference in the NAA/Cho and NAA/Cr ratios (mean [SD]) in the fetal brain in women with diabetes compared with controls (1.74 [0.79] versus 1.79 [0.64],P= .81; and 0.78 [0.28] versus 0.94 [0.36],P= .12, respectively), but the Cho/Cr ratio was marginally lower (0.46 [0.11] versus 0.53 [0.10],P= .04). There was no difference in mean [SD] anterior white, posterior white, and deep gray matter ADC between patients and controls (1.16 [0.12] versus 1.16 [0.08],P= .96; 1.54 [0.16] versus 1.59 [0.20],P= .56; and 1.49 [0.23] versus 1.52 [0.23],P= .89, respectively) or volume of the cerebrum (243.0 mL [22.7 mL] versus 253.8 mL [31.6 mL],P= .38).
  
  
  CONCLUSIONS
  Acquiring multimodal MR imaging of the fetal brain at 3T from pregnant women with diabetes is feasible. Further study of fetal brain metabolism in maternal diabetes is warranted.
authors.affiliation: From the Medical Research Council Centre for Reproductive Health (F.C.D., D.A., A.S., J.P.B.), University of Edinburgh, Queen's Medical Research Institute, Edinburgh, UK Fiona.Denison@ed.ac.uk.
authors.forename: F C
authors.identifier: http://orcid.org/0000-0003-0371-2014
authors.initials: FC
authors.lastname: Denison
authors.affiliation: Clinical Research Imaging Centre (G.M., S.I.K.S.).
authors.forename: G
authors.identifier: http://orcid.org/0000-0001-5531-9703
authors.initials: G
authors.lastname: Macnaught
authors.affiliation: Clinical Research Imaging Centre (G.M., S.I.K.S.).|University/British Heart Foundation Centre for Cardiovascular Science (S.I.K.S., R.M.R.).
authors.forename: S I K
authors.identifier: http://orcid.org/0000-0002-4008-7564
authors.initials: SIK
authors.lastname: Semple
authors.affiliation: Simpson Centre for Reproductive Health (G.T., J.W.), Royal Infirmary, Edinburgh, UK.
authors.forename: G
authors.identifier: http://orcid.org/0000-0003-1339-4160
authors.initials: G
authors.lastname: Terris
authors.affiliation: Simpson Centre for Reproductive Health (G.T., J.W.), Royal Infirmary, Edinburgh, UK.
authors.forename: J
authors.identifier: http://orcid.org/0000-0003-1119-291X
authors.initials: J
authors.lastname: Walker
authors.affiliation: From the Medical Research Council Centre for Reproductive Health (F.C.D., D.A., A.S., J.P.B.), University of Edinburgh, Queen's Medical Research Institute, Edinburgh, UK.|Centre for Clinical Brain Sciences (D.A., J.P.B.), University of Edinburgh, Edinburgh, UK.
authors.forename: D
authors.identifier: http://orcid.org/0000-0003-3123-4638
authors.initials: D
authors.lastname: Anblagan
authors.affiliation: From the Medical Research Council Centre for Reproductive Health (F.C.D., D.A., A.S., J.P.B.), University of Edinburgh, Queen's Medical Research Institute, Edinburgh, UK.
authors.forename: A
authors.identifier: http://orcid.org/0000-0002-4145-5509
authors.initials: A
authors.lastname: Serag
authors.affiliation: University/British Heart Foundation Centre for Cardiovascular Science (S.I.K.S., R.M.R.).
authors.forename: R M
authors.identifier: http://orcid.org/0000-0001-6226-8270
authors.initials: RM
authors.lastname: Reynolds
authors.affiliation: From the Medical Research Council Centre for Reproductive Health (F.C.D., D.A., A.S., J.P.B.), University of Edinburgh, Queen's Medical Research Institute, Edinburgh, UK.|Centre for Clinical Brain Sciences (D.A., J.P.B.), University of Edinburgh, Edinburgh, UK.
authors.forename: J P
authors.identifier: http://orcid.org/0000-0003-3904-8960
authors.initials: JP
authors.lastname: Boardman
mesh_terms: D000328:Adult; D001921:Brain / Q000000981:diagnostic imaging* / Q000196:embryology* / Q000378:metabolism; D016022:Case-Control Studies; D003920:Diabetes Mellitus; D005260:Female; D005333:Fetus / Q000000981:diagnostic imaging* / Q000378:metabolism; D005865:Gestational Age; D006801:Humans; D008279:Magnetic Resonance Imaging; D009682:Magnetic Resonance Spectroscopy / Q000379:methods; D008297:Male; D009035:Mothers; D011247:Pregnancy; D011248:Pregnancy Complications; D012016:Reference Values