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Gestational diabetes mellitus and children's social-emotional development, behavioral problems, and psychological

Inka Mattila¹, Saara Nolvi^2,3, Eeva-Leena Kataja²

¹FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku and Turku University Hospital, Turku, Finland. inka.m.mattila@gmail.com.

Pediatric Research

|June 10, 2025

Background:

This longitudinal cohort study investigated whether gestational diabetes mellitus (GDM) is associated with 2- and 5-year-old children's social-emotional development and whether child sex moderates the association.

Methods:

FinnBrain Birth Cohort Study recruited 3808 pregnant women 2011-2015 in Finnish Turku region and Åland Islands. Their children's social-emotional development at 2 years was measured by Brief Infant Toddler Social Emotional Assessment (BITSEA) (N = 1444, GDM n = 227) and at 5 years by Strengths and Difficulties Questionnaire (SDQ) (N = 1489, GDM n = 225). General linear models were used.

Results:

After adjusting for covariates, GDM was not associated with children's social-emotional development at age 2 years. At age 5, GDM was associated with greater total behavioral difficulties (p = 0.025, for 1-point increase in total score η² = 0.004). Sex-stratified analyses showed GDM was associated with greater internalizing problems in girls at 2 years (p = 0.044, η² = 0.007), and greater conduct problems (p = 0.018, η² = 0.007), hyperactivity/inattention (p = 0.001, η² = 0.014) and total difficulties (p < 0.001, η² = 0.015) in boys at 5 years. Interaction of child's sex and GDM was observed for hyperactivity/inattention (p = 0.015) and total difficulties (p = 0.019) at 5 years.

Conclusion:

GDM may influence children's social-emotional development, behavioral problems, and adjustment-and, furthermore, in a sexually dimorphic manner. Longer follow-up is needed to evaluate long-term stability of findings.

Impact:

Gestational diabetes mellitus (GDM) was associated with greater total behavioral difficulties of offspring at the age of five. GDM was associated with greater internalizing problems in girls at 2 years GDM was associated with greater conduct problems, hyperactivity/inattention and total difficulties in boys at 5 years. GDM may influence children's social-emotional development in a sexually dimorphic manner. Findings call for further study of mechanisms of children's social-emotional development as well as shed light on GDM-related risk factors for early intervention.

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