Gestational diabetes & diabetes in pregnancy
Long-term Neurobehavioral and Metabolic Outcomes in Offspring of Mothers With Diabetes During Pregnancy: A Large, Population-Based Cohort Study in Ontario, Canada
Authors' conclusion
In utero exposure to maternal diabetes was associated with an increase in ADHD, ASD, and cardiometabolic outcomes in offspring, with differences seen across diabetes subtypes. Pregnancy glycemia was associated with cardiometabolic outcomes, but not neurobehavioral outcomes, and provides a potentially modifiable risk factor to decrease cardiometabolic outcomes in offspring.
Study context
- Population
- Mother-infant pairs, deliveries in Ontario, April 1991–March 2018; followed up to 29 years
- Participants
- 3,407,961 mother-infant pairs
- Exposure
- Maternal preexisting diabetes or gestational diabetes vs no diabetes during pregnancy
- Outcome
- Risk of attention deficit hyperactivity disorder (ADHD), autism spectrum disorder (ASD) and cardiometabolic outcomes in offspring
- Follow-up
- Up to 29 years
Methodological detailsCox proportional hazard model, adjusted for confounders
- Cox proportional hazard model
- Adjusted for confounders
Main finding
As reported in the abstract
Offspring outcomes, T1D vs unexposed
Each group vs unexposedEstimate (95% CI)
Type 1 diabetes
aHR (ADHD) 1.43(1.36–1.49)
Type 1 diabetes
aHR (ASD) 1.94(1.80–2.09)
Type 1 diabetes
aHR (diabetes) 4.73(4.34–5.16)
Type 1 diabetes
aHR (hypertension) 2.32(2.07–2.61)
Type 1 diabetes
aHR (CVD) 1.72(1.56–1.90)
Observational data: associations, not effects.
Further findings
Pregnancy HbA1c level and offspring outcomes, among women with preexisting diabetes
- aHR offspring diabetes
- 1.22 (95% CI 1.12-1.32)
- aHR hypertension
- 1.42 (1.29-1.57)
- aHR cardiovascular disease (CVD)
- 1.20 (1.11-1.29)
- No statistically significant association with neurobehavioral outcomes
Original publication
Long-term Neurobehavioral and Metabolic Outcomes in Offspring of Mothers With Diabetes During Pregnancy: A Large, Population-Based Cohort Study in Ontario, Canada. Diabetes Care. Published 31 May 2024. doi:10.
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