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Published on: October 23, 2020
Cognitive function in 6- to 12-year-old offspring of women with Type 1 diabetes
R C Temple1, M Hardiman, M Pellegrini
1Elsie Bertram Diabetes Centre, Norfolk and Norwich University Hospital NHS Trust, Norwich, UK. rosemary.temple@nnuh.nhs.uk
Insights
Children of mothers with Type 1 diabetes show normal overall intelligence but impaired working memory. Specific risk factors for this cognitive difference in offspring remain unidentified in this study.
Area of Science:
- Endocrinology
- Neuroscience
- Developmental Pediatrics
Background:
- Maternal diabetes is a known risk factor for adverse offspring outcomes.
- Previous research indicates potential links between maternal diabetes and later childhood obesity and congenital malformations.
Purpose of the Study:
- To investigate the impact of maternal diabetes on the cognitive function of offspring.
- To assess specific cognitive domains, including working memory, in children exposed to maternal diabetes during gestation.
Main Methods:
- Studied 40 offspring aged 6-12 years born to mothers with Type 1 diabetes.
- Assessed cognitive function using the Wechsler Intelligence Scale for Children, version 4 (WISC-IV).
- Monitored maternal HbA(1c) levels throughout pregnancy.
Main Results:
- Offspring exhibited normal overall full-scale IQ compared to UK normative data.
- Significantly poorer working memory scores were observed in the offspring group compared to controls.
- No correlation was found between working memory deficits and maternal HbA(1c), gestational age, birth weight ratio, or maternal diabetes duration.
Conclusions:
- Offspring of women with Type 1 diabetes demonstrate intact general cognitive abilities but exhibit deficits in working memory.
- Current findings do not identify specific risk factors contributing to the observed working memory impairment.
- Larger studies are needed to further elucidate the mechanisms behind this memory defect and identify potential modifiable risk factors.
Aims:
Maternal diabetes is a recognized risk factor for congenital malformation, perinatal morbidity and obesity in later childhood. The aim of this study is to assess the impact of maternal diabetes on cognitive function in offspring.
Methods:
Participants were 6- to 12-year-old offspring of women with Type 1 diabetes. All women received their antenatal care and delivered at one university hospital. HbA(1c) was monitored monthly throughout pregnancy and cognitive function was assessed using the Wechsler Intelligence Scale for Children, version 4.
Results:
We present results in 40 offspring. There was no difference in overall full-scale IQ compared with UK normative data. However, working memory was poorer than other parts of the Wechsler Intelligence Scale for Children version 4 test and significantly lower compared with UK normative data [8.4 (2.2) vs. 10.1 (3.2), P < 0.01]. We found no correlation between measurement of digit span or HbA(1c) at any stage during pregnancy (r = -0.225 to 0.002), gestational age at delivery (r = -0.178) or infant birthweight ratio (r = -0.176). There was no relationship between working memory score and maternal hypoglycaemia episodes or maternal duration of diabetes. Comparing infants born before (n = 9) or after 37 weeks' gestation, digit span was non-significantly lower [7.9 (1.8) vs. 8.6 (2.4)].
Discussion:
These results suggest offspring of women with Type 1 diabetes have normal overall cognitive function but poorer working memory. We have been unable to identify specific risk factors. Further larger studies are required to increase the understanding of this memory defect and identify any modifiable risk factors.
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