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Study Links Diabetes During Pregnancy to Increased Risk of Neurodevelopmental Disorders in Children
Expectant mothers with diabetes during pregnancy may face an elevated risk of having children with neurodevelopmental disorders such as autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD), according to a recent study. Researchers emphasize that while more research is needed, the findings underscore the critical importance of careful blood sugar management throughout gestation. The study highlights a potential link between diabetes during pregnancy and neurodevelopmental disorders in offspring, including autism and ADHD.
Meta-Analysis Examines Millions of Pregnancies
This extensive meta-analysis, conducted by researchers in China, analyzed data from 202 studies encompassing over 56 million pregnancies. Among these, 110 investigations focused on gestational diabetes – a condition that develops during pregnancy and typically subsides after childbirth – and 80 explored pre-gestational diabetes, which refers to women diagnosed with type 1 or type 2 diabetes prior to conception.
Increased Risk of Neurodevelopmental Issues
The analysis revealed a significant finding: children born to mothers with diabetes during pregnancy exhibited a 28% higher likelihood of developing any neurodevelopmental disorder compared to children of mothers without diabetes. This correlation persisted even after accounting for other potentially contributing factors.
Specific Disorders Analyzed
Upon closer examination of specific conditions, the research team discovered:
- A 25% increased risk of autism spectrum disorder (ASD).
- A 30% increased risk of attention-deficit/hyperactivity disorder (ADHD).
- A 32% increased risk of intellectual disability.
Notably, the study indicated that the risks were more pronounced for women with pre-existing diabetes compared to those who developed gestational diabetes.
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Emphasis on Blood Sugar Monitoring
The researchers reiterated the “imperative” need for “diligent monitoring of maternal glycaemic concentrations throughout pregnancy.” They stated this meta-analysis is the “first comprehensive systematic review” to evaluate neurodevelopmental outcomes in children born to mothers with specific forms of diabetes. While acknowledging the novel insights into potential risks, the team cautioned that their findings, as published in The Lancet, should be “interpreted with caution.”
Expert Commentary on Study Findings
Professor Lucilla Poston, an expert in maternal and foetal health at King’s College London, commented on the study, noting that “the human foetus is exquisitely vulnerable to changes in its environment which may affect life-long health.”
She further observed that the “well conducted” review was strengthened by its “focus on studies that ruled out several factors, such as maternal obesity or socioeconomic status, which could explain the association.”
Causality and Further Research
Prof Poston also highlighted that “while the conclusion is that children born to mothers with diabetes are at risk of neurodevelopmental disorders, all contributing studies were observational.” She emphasized that “causality must be treated with caution” as there was “no attempt to intervene to prevent any effect.” She further noted that “interpretation may be complicated by effects of diabetes treatment, and the international non-conformity in the diagnosis of gestational diabetes.”
However, Prof Poston also pointed to other evidence suggesting causality, “including many studies in experimental animals.” She added that “data is emerging from MRI imaging of the brains of children exposed to maternal diabetes, showing structural and functional changes in the hypothalamus,” a brain region “intricately involved in both mental and physical health.” For these reasons, “diabetes prevention, screening and treatment remain critically important not only for the health of the mother, but also her child.”