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.

Nutrients
|June 26, 2026
PubMed

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.

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