Assessment of Attention Deficits in Adolescent Offspring Exposed to Maternal Type 1 Diabetes

Abstract

ObjectiveThe aim of this study was to examine the potential association between intrauterine exposure to maternal diabetes and attention deficits in the offspring.Research design and methodsAdolescent offspring of a prospectively followed cohort of women with type 1 diabetes (n = 269) and a control group from the background population (n = 293) participated in a follow-up assessment in 2012–2013. We used scores from Conners Continuous Performance Test II to assess attention and based on a principal component analysis we evaluated scores on five different attention factors: focused attention, vigilance, hyperactivity/impulsivity, sustained attention and response style.ResultsA higher frequency of the exposed offspring had a parent/self-reported use of Attention Deficit Hyperactivity Disorder (ADHD) medication compared to the control group (2.2% vs. 0.0%, p = 0.01). Clinical significant differences between adolescents exposed to maternal diabetes and unexposed controls were not found in either single scores on Conners Continuous Performance Test or on any of the five attention factors identified.ConclusionsExposure to maternal type 1 diabetes did not seem to increase the risk of attention deficits in the adolescent offspring. However, a higher self-reported use of ADHD medication in the exposed group could suggest a difference in attention not revealed by the applied test.

<p>The association of maternal diabetes with attention deficit and hyperactivity disorder in offspring: a meta-analysis</p>

“…Unfortunately, publication bias was identified according to Egger’s test ( t =6.56, P =0.003) (Table 4), indicating that the estimated effect was probably overstated due to publication of positive results. Since only the Li et al’s11 study investigated the effect of maternal diabetes in Chinese, the remaining studies 10,12,13,19,20 that were conducted in Caucasian population demonstrated the risk in this race (RR: 1.37, 95% CI: 1.24–1.51). Subgroup analyses revealed that T1D increased the risk by 36% (RR: 1.36, 95% CI: 1.23–1.50) 12,13,19.…”

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“…Lastly, we were unable to replicate previous CPT-II factor structures (Bytoft et al, 2017;Vertinski et al, 2014) and the use of exploratory methods may have weakened associations among our neurocognitive predictors and outcomes.…”

“…Evidence has been inconsistent regarding the validity of this factor structure. To our knowledge no study has successfully replicated a previously published Conners CPT factor structure despite multiple attempts (Bytoft et al, 2017;Vertinski et al, 2014).…”

“…The current study examined whether impairments in attention and inhibition, as measured by the Conners' Continuous Performance Test, Second Edition (CPT-II; , explain relations between ADHD symptoms and future risk for objective, criterion-based crashes and near-crashes. Described as a go/no-go paradigm, the CPT-II assesses inhibitory control as well as multiple subcomponents of attention (Bytoft et al, 2017;Egeland & Kovalik-Gran, 2010a;Egeland & Kovalik-Gran, 2010b) and has been deemed to possess ecological validity with motor vehicle driving due to the shared monotonous nature of each task . The CPT-II manipulates the interstimulus interval (ISI) within a fixed task duration and go/no-go ratio, resulting in performance markers that have been shown to diffusely align with ADHD symptoms of inattention, hyperactivity, and impulsivity .…”

“…four (Conners, 2014), and five (Egeland & Kovalik-Gran, 2010a;Bytoft et al, 2017) factor solutions based on exploratory models.…”