Prenatal Glucose Intolerance and Child Neurodevelopmental Disorders

Area of Science:

• Obstetrics and Gynecology
• Pediatrics
• Neuroscience

Background:

• Gestational diabetes mellitus (GDM) is a known risk factor for adverse neurodevelopmental outcomes in children.
• Understanding the specific timing and sex-based differences in these associations is crucial for targeted prevention and intervention strategies.

Purpose of the Study:

• To investigate the association between prenatal glucose intolerance, including GDM and impaired glucose tolerance (IGT), and the risk of neurodevelopmental disorders (NDD) in offspring.
• To examine how gestational timing of GDM diagnosis and child sex modify these associations.

Main Methods:

• A population-based case-control study utilizing electronic health records from mother-child pairs in Northern California.
• GDM was categorized by gestational timing (early, standard, late), and IGT was defined by elevated glucose screening tests without a GDM diagnosis.
• Neurodevelopmental disorders, including autism spectrum disorder (ASD) and developmental delay, were identified from medical records. Multivariable logistic regression models were used to estimate adjusted odds ratios (aOR), with effect modification assessed by GDM timing and child sex.

Main Results:

• Overall, GDM was not significantly associated with increased odds of ASD or developmental delay.
• However, GDM was associated with increased odds of ASD specifically among females (aOR, 2.05) and early GDM was associated with increased ASD odds in females (aOR, 3.23).
• Prenatal IGT was associated with increased odds of developmental delay in females only (aOR, 3.25).

Conclusions:

• The association between GDM and NDD is dependent on gestational timing and child sex, highlighting a sex-specific vulnerability.
• Prenatal IGT also demonstrates sex-specific associations with developmental delay, reinforcing the impact of maternal glucose metabolism on child neurodevelopment.
• These findings underscore the importance of considering maternal health during pregnancy for optimizing child neurodevelopmental outcomes.