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Maternal Diabetes and Cognitive Performance in the Offspring: A Systematic Review and Meta-Analysis
Maria Camprubi Robles1, Cristina Campoy2, Llenalia Garcia Fernandez3
1Abbott Nutrition, Research and Development-University Science Park, Granada, Spain.
Insights
Maternal diabetes during pregnancy may negatively impact infant cognitive development. This systematic review found lower mental and psychomotor scores in infants of diabetic mothers, suggesting a need for further research.
Area of Science:
- Neuroscience
- Developmental Psychology
- Maternal-Fetal Medicine
Background:
- Gestational diabetes is a common pregnancy complication with potential adverse effects on maternal and child health.
- Existing research on the impact of maternal diabetes on child cognitive abilities is conflicting.
- Understanding these effects is crucial for early intervention and improved child outcomes.
Purpose of the Study:
- To systematically review and meta-analyze existing studies comparing cognitive function in children exposed to maternal diabetes versus healthy controls.
- To assess the impact of maternal diabetes on various domains of child cognitive development.
Main Methods:
- A comprehensive literature search was conducted across multiple electronic databases up to January 31, 2015.
- Included studies assessed cognitive abilities in children up to 14 years using standardized neuropsychological tests.
- A random effects model was employed for meta-analysis of 12 studies involving 6,140 participants.
Main Results:
- Infants aged 1-2 years born to mothers with diabetes showed significantly lower mental and psychomotor development scores compared to controls.
- Effect sizes indicated moderate negative impacts on mental (-0.41) and psychomotor (-0.31) development.
- Evidence suggests a potential association with decreased intelligence quotient scores in school-aged children, though heterogeneity was noted.
Conclusions:
- The association between maternal diabetes and adverse cognitive/psychomotor development in offspring warrants caution.
- Current findings are primarily from observational studies, and direct causality of intrauterine hyperglycemia remains uncertain.
- Further large-scale trials are needed to confirm the impact of gestational diabetes mellitus on offspring central nervous system development.
Objective:
Diabetes during gestation is one of the most common pregnancy complications associated with adverse health effects for the mother and the child. Maternal diabetes has been proposed to negatively affect the cognitive abilities of the child, but experimental research assessing its impact is conflicting. The main aim of our study was to compare the cognitive function in children of diabetic and healthy pregnant women.
Methods:
A systematic review and meta-analysis was conducted through a literature search using different electronic databases from the index date to January 31, 2015. We included studies that assessed the cognitive abilities in children (up to 14 years) of diabetic and non-diabetic mothers using standardized and validated neuropsychological tests.
Results:
Of 7,698 references reviewed, 12 studies involving 6,140 infants met our inclusion criteria and contributed to meta-analysis. A random effect model was used to compute the standardized mean differences and 95% confidence interval (CI) were calculated. Infants (1-2 years) of diabetic mothers had significantly lower scores of mental and psychomotor development compared to control infants. The effect size for mental development was -0.41 (95% CI -0.59, -0.24; p<0.0001) and for psychomotor development was -0.31 (95% CI -0.55, -0.07; p = 0.0125) with non-significant heterogeneity. Diabetes during pregnancy could be associated with decreased intelligence quotient scores in school-age children, although studies showed significant heterogeneity.
Conclusion:
The association between maternal diabetes and deleterious effects on mental/psychomotor development and overall intellectual function in the offspring must be taken with caution. Results are based on observational cohorts and a direct causal influence of intrauterine hyperglycemia remains uncertain. Therefore, more trials that include larger populations are warranted to elucidate whether gestational diabetes mellitus (GDM) has a negative impact on offspring central nervous system (CNS).
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