Maternal medical conditions during pregnancy and gross motor development up to age 24 months in the Upstate KIDS study

Abstract

Aims We examined whether children of mothers with a medical condition diagnosed before or during pregnancy took longer to achieve gross motor milestones up to age 24 months. Methods We obtained information on medical conditions using self-reports, birth certificates, and hospital records in 4909 mothers participating in Upstate KIDS, a population-based birth cohort. Mothers reported on their children’s motor milestone achievement at 4, 8, 12, 18, and 24 months of age. Results After adjustment for covariates (including prepregnancy body mass index), children of mothers with gestational diabetes took longer to achieve sitting without support [Hazard Ratio (HR)=0.84, 95%CI:0.75-0.93), walking with assistance (HR=0.88, 95%CI:0.77-0.98) and walking alone (HR=0.88, 95%CI:0.77-0.99) than children of women with no gestational diabetes. Similar findings emerged for maternal diabetes. Gestational hypertension was associated with a longer time to achieve walking with assistance. These associations did not change after adjustment for gestational age or birth weight. Severe hypertensive disorders of pregnancy were related to a longer time to achieve milestones, but not after adjustment for perinatal factors. Interpretation Children exposed to maternal diabetes, gestational or pre-gestational, may take longer to achieve motor milestones than non-exposed children, independent of maternal obesity.

Motor Developmental Outcomes in Children Exposed to Maternal Diabetes during Pregnancy: A Systematic Review and Meta-Analysis

“…Adane et al [ 16 ] found that children born to mothers with diabetes had a higher risk of developmental delay, particularly gross motor skills, compared to the control group. This was consistent with Ghassabian et al [ 35 ], who found that children born to mothers with GDM took longer to achieve major motor developmental milestones, such as sitting without support or walking.…”

“…Three studies used multiple regression analysis in reporting its findings and could not be included in our meta-analysis as the statistical coefficient of motor development cannot be reliably extracted from the regression equations (see Table 3 ). This resulted in the exclusion of these studies prior to our meta-analysis [ 16 , 17 , 35 ]. Outcome measures were heterogeneous across studies.…”

“…Ghassabian et al [35] World Health Organisation (WHO) major milestones/time to achieve motor milestones…”

Maternal preconception weight trajectories, pregnancy complications and offspring’s childhood physical and cognitive development

“…The existing evidence has also not shown a consistent picture about this possible link, 12 , 13 perhaps due to variations in the child outcomes measured or confounders adjusted for during analysis. For instance, a few previous studies have suggested that children born to diabetic or hypertensive mothers during pregnancy were more likely to have poorer physical 18 , 19 or cognitive development 14 40 , 41 However, unlike the current study, most of these studies did not adjust for key confounders such as maternal pre-pregnancy obesity, and therefore, negative associations between maternal diabetes during pregnancy or HDP and childhood outcomes might have been due to such confounders or the effect might have been limited to younger infants 42 …”

“…, 13 For instance, as compared to children of women without GDM, children born to women with GDM have been shown to have poorer, 14 , 15 better 16 or equivalent 17 cognitive and language skills. Intrauterine exposure to pre-eclampsia has been also shown to have a negative impact on the motor development of adolescents, 18 while in infants (⩽2 years) mixed, 19 null 20 or contradictory 21 findings have been observed. Because most of these studies were small studies, which did not adjust for potential confounders such as pre-pregnancy obesity, authors of recent systematic reviews on this topic 12 , 13 have called for further research.…”