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Maternal glucose tolerance in pregnancy and child cognitive and behavioural problems in early and mid-childhood
Tingting Xu1,2,3, Sabrina Faleschini4, Sheryl L Rifas-Shiman3
1China Center for Health Development Studies, Peking University, Beijing, China.
Insights
Maternal gestational diabetes mellitus was linked to slightly lower cognitive scores in early childhood. However, abnormal glucose tolerance during pregnancy did not show lasting effects on child cognition or behavior in mid-childhood.
Area of Science:
- Obstetrics and Gynecology
- Developmental Psychology
- Pediatric Neurology
Background:
- Maternal abnormal glucose tolerance in pregnancy may impact offspring neurodevelopment.
- Few prospective studies have examined this association across multiple childhood stages.
Purpose of the Study:
- To investigate the association between maternal abnormal glucose tolerance during pregnancy and offspring cognitive and behavioral outcomes in early and mid-childhood.
Main Methods:
- Prospective cohort study of 1421 children (Project Viva).
- Maternal glucose tolerance assessed at 26-28 weeks gestation.
- Child cognition and behavior assessed using validated instruments at mean ages 3.3 and 7.9 years.
- Linear regression models adjusted for multiple confounders.
Main Results:
- Offspring of mothers with gestational diabetes mellitus (GDM) showed lower visual-motor integration scores in early childhood (-3.09 points).
- No significant associations were found between any maternal abnormal glucose tolerance category and cognitive or behavioral outcomes in mid-childhood.
Conclusions:
- Gestational diabetes mellitus may be associated with subtle cognitive deficits in early childhood.
- Maternal abnormal glucose tolerance during pregnancy does not appear to have a sustained impact on child cognitive or behavioral development in mid-childhood.
Background:
Maternal abnormal glucose tolerance during pregnancy may adversely affect offspring cognition and behaviour, but few prospective studies investigated this association at multiple points throughout childhood.
Objectives:
We hypothesised that maternal abnormal glucose tolerance is associated with child cognitive and behavioural outcomes in early and mid-childhood.
Methods:
We examined the associations of maternal abnormal glucose tolerance at 26-28 weeks of pregnancy with offspring cognitive and behavioural scores in 1421 children in the Project Viva pre-birth cohort. In early (mean 3.3 years) and mid-childhood (mean 7.9 years), we measured child cognition using validated instruments, the Kaufman Brief Intelligence Test, Wide Range Assessment of Memory and Learning, and the Wide Range Assessment of Visual Motor Abilities (WRAVMA); we assessed parent- and teacher-rated behavioural outcomes with the Strengths and Difficulties Questionnaire and the Behavioural Rating Inventory of Executive Function. We used linear regression models adjusted for potential confounders (maternal race/ethnicity, pre-pregnancy BMI, intelligence, age, parity, smoking status, education, and household income at enrolment, in addition to child's sex and age at assessment).
Results:
Of 1421 mothers, 69 (4.9%) had gestational diabetes mellitus, 43 (3.0%) impaired glucose tolerance, 122 (8.6%) isolated hyperglycaemia, and 1187 (83.5%) normal glucose tolerance. Offspring born to women with gestational diabetes mellitus had lower total WRAVMA scores (-3.09 points; 95% CI -6.12, -0.05) in early childhood compared with offspring of women with normal glucose tolerance. None of the abnormal glucose tolerance categories during pregnancy were associated with any of the cognitive outcomes (verbal, non-verbal, and visual motor scores) or behavioural measures in mid-childhood.
Conclusions:
Children born to mothers who had gestational diabetes mellitus had slightly lower scores on one cognitive test in early childhood. We found no evidence to support that maternal abnormal glucose tolerance was associated with cognitive or behavioural development in mid-childhood.
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