Gestational Diabetes Linked to Increased Risk of ADHD, Autism in Children
A comprehensive meta-analysis has revealed that gestational diabetes, a diabetes type that arises during pregnancy, may significantly impact both maternal and child cognitive health. The findings, which will be presented at the upcoming Annual Meeting of the European Association for the Study of Diabetes (EASD) in Vienna, underscore the long-term implications for children’s brain development linked to this common pregnancy condition.
The study analyzed data from nearly 50 scientific studies, encompassing over nine million pregnancies across 20 countries. Results indicate that women who developed gestational diabetes experienced notable declines in their cognitive function. Furthermore, their children were at a heightened risk for developmental disorders, including Attention-Deficit/Hyperactivity Disorder (ADHD) and autism spectrum disorder (ASD).
Impact on Mothers and Children
Gestational diabetes affects approximately 14 percent of pregnancies globally and is increasingly prevalent, particularly among women who are older, have obesity, possess a family history of diabetes, or belong to non-white ethnic groups. Although the condition often resolves after childbirth, it is associated with various complications, such as high blood pressure, cesarean delivery, and the development of type 2 diabetes in the future.
For infants, exposure to gestational diabetes can lead to premature birth, elevated birth weight, and low blood sugar levels after delivery. The new findings suggest that the effects of gestational diabetes extend beyond the immediate pregnancy phase. Professor Ling-Jun Li from the National University of Singapore’s School of Medicine, the study’s lead author, emphasized the urgent need to address this public health issue, highlighting its substantial risks for cognitive dysfunction in both mothers and their offspring.
The meta-analysis evaluated 48 observational studies published up to April 2024. Five studies focused on maternal cognitive function during pregnancy, revealing that women with gestational diabetes scored an average of 2.47 points lower on the Montreal Cognitive Assessment, a 30-point scale used to assess mild cognitive impairment, compared to those without the condition.
In terms of child development, the analysis presented alarming statistics. Children exposed to gestational diabetes in utero exhibited lower IQ scores, averaging nearly 4 points less than their peers. Additionally, their verbal crystallized intelligence, which pertains to language comprehension and communication skills, was reduced by more than 3 points.
The study further indicated that children born to mothers with gestational diabetes had a 45 percent higher risk of developmental delays, a 36 percent increased likelihood of ADHD, and a staggering 56 percent greater risk of ASD. Notably, researchers observed no significant differences in overall brain structure or general cognitive scores, suggesting that gestational diabetes may specifically affect certain cognitive and behavioral domains.
Understanding the Mechanisms
While the exact mechanisms by which gestational diabetes influences brain development remain unclear, researchers propose several potential factors. Chronic inflammation, oxidative stress, reduced oxygen supply, and elevated insulin levels during pregnancy may disrupt the normal formation of the developing brain. Such biological stresses could manifest later as challenges related to learning, attention, and social communication.
Professor Li highlighted the importance of monitoring developmental milestones in children born to mothers diagnosed with gestational diabetes, stating, “It is crucial for these mothers to take care of their own health during pregnancy as well as their child’s development after birth.” She acknowledged that current evidence on postpartum neurocognitive function is limited, making it difficult to draw definitive conclusions at this stage.
For women at risk of developing gestational diabetes but not yet diagnosed, Li recommends diligent monitoring of blood sugar levels under medical supervision, which may include early screening and maintaining a healthy diet and lifestyle during pregnancy. Ongoing clinical trials are exploring strategies for optimal glycemic control in gestational diabetes, with promising short-term results for maternal and neonatal outcomes.
Nevertheless, Professor Li noted that evidence regarding long-term neurodevelopmental conditions such as ADHD and autism remains scarce. “We will need to await results from longer follow-up randomized controlled trials to confirm whether these approaches yield benefits in that domain,” she stated.
The implications of this research highlight the critical need for awareness and intervention strategies surrounding gestational diabetes, emphasizing the importance of both maternal health and child development in ensuring better long-term outcomes.
