A new study has found a link between diabetes during pregnancy and an increased risk of neurodevelopmental disorders like autism and ADHD in children.
Chinese researchers, who conducted a meta-analysis, said while more research is needed, “diligent monitoring” of blood sugar levels throughout pregnancy is “imperative”.
The analysis included 202 studies, including more than 56 million pregnancies. Of these, 110 studies looked at gestational diabetes – which develops during pregnancy and usually goes away after birth – and 80 looked at pre-gestational diabetes, when a woman has a type 1 or type 2 diabetes diagnosis before pregnancy.
The analysis found that the children of mothers with diabetes in pregnancy had a 28 per cent increased risk of having any neurodevelopmental disorder compared to children whose mothers did not have the condition, even in studies which accounted for other factors that might explain the association.
Researchers also found there was a 25 per cent increased risk of autism spectrum disorder (ASD), a 30 per cent increased risk of attention-deficit/hyperactivity disorder (ADHD), and a 32 per cent increased risk of intellectual disability.
Risks were higher in women who had diabetes before pregnancy compared to women who developed gestational diabetes.
Researchers said that the “diligent monitoring of maternal glycaemic concentrations throughout pregnancy is imperative”.
“To the best of our knowledge, this is the first comprehensive systematic review and meta-analysis to assess neurodevelopmental outcomes in children born to mothers with specific types of diabetes,” the team added.
They also warned that while the findings, published in The Lancet, “provide novel insights into the potential risks”, they should be “interpreted with caution”.
Symptoms of gestational diabetes
NHS
Gestational diabetes does not usually cause any symptoms.
However, some women may develop symptoms if their blood sugar levels get too high, such as:
- increased thirst
- needing to pee more often than usual
- a dry mouth
- tiredness
- blurred eyesight
- genital itching or thrush
Responding to the study, Lucilla Poston, a professor of maternal and foetal health at King’s College London, said: “The human foetus is exquisitely vulnerable to changes in its environment which may affect life-long health.”
She added that the “well conducted” review “benefits from a focus on studies that ruled out several factors, such as maternal obesity or socioeconomic status which could explain the association”.
“While the conclusion is that children born to mothers with diabetes are at risk of neurodevelopmental disorders, all contributing studies were observational, with no attempt to intervene to prevent any effect, and causality must be treated with caution,” Prof Poston said.
“As appreciated by the authors, interpretation may be complicated by effects of diabetes treatment, and the international non-conformity in the diagnosis of gestational diabetes.
“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 not only for the health of the mother, but also her child.”
