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Infants of Mothers With Diabetes and Subsequent Attention Deficit Hyperactivity Disorder: A Retrospective Cohort
Chien-Heng Lin1,2, Wei-De Lin3, I-Ching Chou4,5
1Division of Pediatrics Pulmonology, China Medical Univeristy Children's Hospital, Taichung City, Taiwan.
Insights
Infants born to mothers with diabetes (IDMs) face a higher risk of developing attention deficit hyperactivity disorder (ADHD). This risk is particularly elevated in male and full-term infants, highlighting the need for early screening.
Area of Science:
- Pediatrics
- Neurodevelopmental Disorders
- Endocrinology
Background:
- Maternal diabetes mellitus (DM) is a known risk factor for various offspring complications.
- Limited data exist on the specific impact of maternal pregestational and gestational diabetes on neurodevelopmental outcomes.
- Attention deficit hyperactivity disorder (ADHD) is a significant concern in offspring of mothers with diabetes.
Purpose of the Study:
- To investigate the association between maternal diabetes and the risk of ADHD in infants.
- To compare ADHD risk in infants of mothers with diabetes (IDMs) versus those without (non-IDMs).
- To analyze potential perinatal risk factors associated with ADHD in IDMs.
Main Methods:
- Retrospective cohort study of infants born between 2006 and 2012.
- Inclusion of infants born to mothers with gestational or pregestational diabetes (IDM group) and mothers without diabetes (non-IDM group).
- Follow-up assessment for ADHD diagnosis and analysis of perinatal factors.
Main Results:
- Infants of mothers with diabetes (IDMs) showed a significantly higher overall risk of ADHD (OR 2.6, p=0.03).
- The risk of ADHD was notably higher in male IDMs (OR 3.78, p=0.001) and full-term IDMs (OR 4.5, p=0.03).
- No significant differences in assumed perinatal risk factors were identified among IDMs.
Conclusions:
- Maternal diabetes is associated with an increased incidence of ADHD in offspring.
- Male and full-term infants born to diabetic mothers are at a higher risk for ADHD.
- Pediatricians should prioritize early identification and assessment of neurodevelopmental disorders, particularly ADHD, in children of diabetic mothers.
Abstract:
Background: Maternal diabetes mellitus (DM) increases the risk of fetal, neonatal, and long-term complications in offspring. Although this has been widely known for decades, data are limited regarding the effect of maternal pregestational and gestational diabetes on the subsequent neurodevelopmental outcome of offspring. This study investigated whether infants of mothers with diabetes (IDMs) were associated with a risk of subsequent attention deficit hyperactivity disorder (ADHD). Objectives: We collected data from newborn infants born to mothers with gestational or pregestational diabetes at China Medical University Children's Hospital between January 1, 2006, and December 31, 2012. These patients were followed to evaluate their risk of ADHD (IDM group) compared with that for those born to mothers without DM (non-IDM group). Several assumed perinatal risk factors accompanying the IDMs were also analyzed. Results: Overall, 104 patients with average gestational ages of 36.5 weeks were included in the IDM group. Additionally, 110 patients with average gestational ages of 36.6 weeks were included in the non-IDM group. Compared with non-IDMs (reference), the overall risk of ADHD in IDMs was 2.6 [95% confidence interval (CI)P, 1.11-5.90; p = 0.03]. Furthermore, the risk of ADHD among male (OR, 3.78; 95% CI, 1.37-10.3; p = 0.001) and full-term infants [odds ratio (OR), 4.5; 95% CI, 1.16-17.6; p = 0.03] in the IDMs was higher than that in the non-IDM group. No significant differences were found among IDMs for the assumed perinatal risk factors that were analyzed. Conclusions: The study revealed a higher incidence rate of ADHD in IDMs, especially male and full-term infants. It is crucial for pediatricians to identify the early symptoms neurodevelopmental disorders, especially ADHD, in children of diabetic mothers to initiate proper assessment and treatment.
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