Identification of Heterogeneous Cortical Thickness Patterns Associated with Prenatal Gestational Diabetes Exposure: A...

Area of Science:

• Neuroscience
• Developmental Biology
• Public Health

Background:

• Prenatal exposure to gestational diabetes mellitus (GDM) is associated with adverse outcomes in offspring.
• The heterogeneity of neuroanatomical patterns in GDM-exposed youth remains unclear.

Purpose of the Study:

• To identify distinct cortical thickness subtypes in GDM-exposed youth.
• To examine associations between these subtypes and anthropometric, neurocognitive, psychiatric/behavioral, and neuroimaging measures.
• To analyze longitudinal developmental trajectories of these subtypes.

Main Methods:

• Utilized the Adolescent Brain Cognitive Development (ABCD)® data, a multisite longitudinal study.
• Applied unsupervised machine learning (Subtype and Stage Inference - SuStaIn) to structural MRI data from 573 GDM-exposed youth and 2854 controls.
• Conducted posthoc longitudinal analyses on a subset of GDM-exposed youth with 1-, 2-, and 4-year follow-ups.

Main Results:

• Identified two distinct cortical thickness subtypes in GDM-exposed youth.
• Subtype 1 showed insula involvement, associated with greater height and weight.
• Subtype 2 exhibited frontal involvement, linked to higher ADHD prevalence, steeper cortical thinning, and a smaller decline in OCD prevalence over time.

Conclusions:

• Gestational diabetes mellitus exposure is associated with two distinct offspring cortical thickness subtypes.
• These subtypes differ in inferred regional ordering patterns and clinical associations.
• One subtype is linked to anthropometric measures, while the other is associated with psychiatric measures and accelerated cortical thinning.