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Maternal Glucose Metabolism and Emotional and Behavioral Problems in Offspring: Modification by Erythrocyte
Xuanqing He1, Sufang Duan2, Jian He2
1Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China.
Insights
Maternal glucose metabolism during pregnancy is linked to children's emotional and behavioral problems. Polyunsaturated fatty acids (PUFAs) may modify these risks, suggesting a potential protective role for n-3 PUFAs.
Area of Science:
- Reproductive Health
- Pediatric Neurobehavioral Outcomes
- Nutritional Biochemistry
Background:
- Gestational diabetes mellitus (GDM) and continuous glucose metabolism markers impact offspring neurobehavioral development.
- The role of polyunsaturated fatty acids (PUFAs) in modifying the relationship between maternal glucose metabolism and child emotional/behavioral problems is not well understood.
Purpose of the Study:
- To investigate the association between maternal glucose metabolism during pregnancy and emotional/behavioral problems in children at age 5.
- To examine the potential modifying effect of maternal erythrocyte PUFAs on this association.
Main Methods:
- Prospective birth cohort study of 481 mother-child pairs.
- Maternal glucose metabolism assessed via GDM diagnosis, fasting plasma glucose (FPG), oral glucose tolerance test (OGTT) at 1h and 2h, hemoglobin A1c (HbA1c), insulin, and HOMA-IR.
- Maternal erythrocyte PUFAs quantified; children's emotional/behavioral problems assessed using the Strengths and Difficulties Questionnaire (SDQ).
Main Results:
- Elevated maternal FPG, 1h OGTT glucose, and HOMA-IR were associated with increased risk of abnormal child total difficulties scores.
- Maternal insulin levels showed a positive association with abnormal difficulties in girls (interaction effect).
- Higher maternal n-3 PUFA and lower n-6 PUFA levels attenuated the risk of glucose metabolism-related child emotional and behavioral problems.
Conclusions:
- Maternal glucose metabolism during pregnancy is a significant risk factor for emotional and behavioral problems in children.
- Maternal PUFA biomarkers, particularly n-3 and n-6 PUFAs, may play a crucial role in modifying these glucose-related neurobehavioral outcomes.
Abstract:
Background: Gestational diabetes mellitus (GDM) adversely affects offspring neurobehavioral outcomes, yet evidence regarding continuous markers of maternal glucose metabolism remains limited. Although polyunsaturated fatty acids (PUFAs) have been shown to affect associations between glucose metabolism and respiratory outcomes, their effects on children's emotional and behavioral problems remain unclear. This study investigated the association between maternal glucose metabolism and emotional and behavioral problems in children and the potential modifying effect of maternal erythrocyte PUFAs. Methods: This prospective birth cohort included 481 mother-child pairs. Maternal glucose metabolism during pregnancy was assessed using GDM diagnosis via a 75 g oral glucose tolerance test (OGTT), fasting plasma glucose (FPG), 1 h and 2 h OGTT glucose, hemoglobin A1c (HbA1c), insulin, and insulin resistance (HOMA-IR). Maternal erythrocyte PUFAs were quantified by gas chromatography. Children's emotional and behavioral problems at age 5 years were assessed using the Strengths and Difficulties Questionnaire (SDQ). Generalized linear models were used to evaluate associations, including multiplicative interaction terms between glucose metabolism indicators and PUFAs. Results: Maternal FPG (OR = 1.63; 95%CI: 1.08-2.47), OGTT-1h glucose (OR = 1.84; 95%CI: 1.08-3.12), and HOMA-IR (OR = 1.52; 95%CI: 1.01-2.27) were each positively associated with an increased risk of abnormal total difficulties scores in children. Maternal insulin levels were positively associated with abnormal total difficulties scores in girls (p for interaction < 0.05). Higher maternal n-3 PUFA levels and lower n-6 PUFA levels attenuated the risk of glucose metabolism-related emotional and behavioral problems in children. Conclusion: Maternal glucose metabolism was associated with increased risk of emotional and behavioral problems in children. PUFA biomarkers could modify glucose-related emotional and behavioral outcomes in children.
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