What risk does Diabetes cause in pregnancy?

 


Diabetes in pregnancy is associated with an increased risk of autism and ADHD

Diabetes in pregnancy is associated with an increased risk of autism and attention deficit hyperactivity disorder (ADHD), a large meta-analysis has suggested.

A Chinese study published in The Lancet Diabetes and Endocrinology looked at data from 202 observational studies with over 56 million pairs of mothers and children.

After taking into account factors that might skew the results, including obesity and socioeconomic status, the analysis showed that children of mothers who had diabetes in pregnancy had a 28% increased risk of neurodevelopmental disorder, compared to children of mothers without diabetes.

About specific disorders, the data suggested children of mothers with maternal diabetes had a 25% increased risk of autism spectrum disorder, a 30% increased risk of ADHD, and a 32% increased risk of intellectual disability, compared to children whose mother did not have diabetes.

Risks were higher in women who had diabetes before pregnancy compared to women who developed gestational diabetes.

The results show the importance of ‘diligent monitoring of maternal glycemic concentrations throughout pregnancy’, the researchers concluded.

As there is still currently little evidence of a causal link, more research is needed on the reasons for the association, they added.  Looking to improve staff motivation within your practice? On the hunt for new technologies to streamline processes? Interested in hearing about winning strategies for practice management? Then sign up for Management in Practice Manchester today – tickets are free for all primary care management roles:

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‘By highlighting these associations, we aim to raise awareness and encourage holistic actions from clinicians, policymakers, and researchers, thereby improving health outcomes for both mothers and their children,’ they said.

The study said: ‘Maternal diabetes is associated with an increased risk of neurodevelopmental disorders and impaired neurodevelopmental performance in children.

‘Further high-quality research is needed to establish causality and clarify the associations between specific types of diabetes and the full spectrum of neurodevelopmental disorders.’

Professor Lucilla Poston, professor of maternal and fetal health at King’s College London, said the review had found that a range of neurodevelopmental disorders were strongly linked to pre-existing maternal type 1 diabetes, type 2 diabetes, and also, but less so, to gestational diabetes.

The results were observational, and interpretation may be complicated by effects of diabetes treatment, and differences around the world in the diagnosis of gestational diabetes, she explained.

She added: ‘However, other evidence does imply causality, including many studies in experimental animals.

‘Also, data is emerging from MRI imaging of the brains of children exposed to maternal diabetes, showing structural and functional changes in the hypothalamus, a region of the brain intricately involved in both mental and physical health.

‘For this and other reasons, diabetes prevention, screening, and treatment remain critically important for the mother's health and her child.’

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