The Influence of Gestational Diabetes on Neurodevelopment of Children in the First Two Years of Life: A Prospective Study

Abstract

ObjectiveAnalyze the relation of gestational diabetes and maternal blood glucose levels to early cognitive functions in the first two years of life.MethodsIn a prospective Singaporean birth cohort study, pregnant women were screened for gestational diabetes at 26–28 weeks gestation using a 75-g oral glucose tolerance test. Four hundred and seventy three children (n = 74 and n = 399 born to mothers with and without gestational diabetes respectively) underwent neurocognitive assessments at 6, 18, and/or 24 month, including electrophysiology during an attentional task and behavioral measures of attention, memory and cognition.ResultsGestational diabetes is related to left hemisphere EPmax amplitude differences (oddball versus standard) at both six (P = 0.039) and eighteen months (P = 0.039), with mean amplitudes suggesting offspring of mothers with gestational diabetes exhibit greater neuronal activity to standard stimuli and less to oddball stimuli. Associations between 2-hour maternal glucose levels and the difference in EPmax amplitude were marginal at 6 months [adjusted β = -0.19 (95% CI: -0.42 to +0.04) μV, P = 0.100] and significant at 18 months [adjusted β = -0.27 (95% CI: -0.49 to -0.06) μV, P = 0.014], and the EPmax amplitude difference (oddball-standard) associated with the Bayley Scales of Infant and toddler Development-III cognitive score at 24 months [β = 0.598 (95% CI: 0.158 to 1.038), P = 0.008].ConclusionGestational diabetes and maternal blood glucose levels are associated with offspring neuronal activity during an attentional task at both six and eighteen months. Such electrophysiological differences are likely functionally important, having been previously linked to attention problems later in life.

Exposure to gestational diabetes mellitus induces neuroinflammation, derangement of hippocampal neurons, and cognitive changes in rat offspring

“…Interestingly, these alterations in neuronal arrangement in the young adult GDM offspring were associated with impaired recognition memory, reduced anxiety level, and inattentive behavior. Therefore, offspring of GDM dams exhibit many of the cognitive changes reported in some clinical cohort studies of populations of children from mothers diagnosed with diabetes during pregnancy [3–6]. …”

“…The combination of human cohort studies and research using rodent models with controlled pre- and postnatal conditions has demonstrated that diabetes during pregnancy during critical stages of development affects health outcomes in the offspring [2]. Several human cohort studies have linked diabetes during pregnancy with impaired cognitive abilities [3–6] and psychiatric disorders [7, 8] in the offspring. Similar correlations exist between poor quality early childhood diets and cognitive performance [9, 10].…”

Thyroid Dysfunction and Type 2 Diabetes Mellitus: Screening Strategies and Implications for Management

“…Hypothyroidism can complicate the pregnancy and cause pregnancy-induced hypertension, preeclampsia, abruptio placentae, postpartum haemorrhage, impaired neurodevelopment of the infant, preterm delivery, and low birth weight [30,31]. Children born to hypothyroid mothers or to those with GDM have impaired neuropsychological development [32,33].…”

Gestational Diabetes Triggers Oxidative Stress in Hippocampus and Cerebral Cortex and Cognitive Behavior Modifications in Rat Offspring: Age- and Sex-Dependent Effects

“…Some studies in humans have described that maternal diabetes affects the intrauterine development of the nervous system and cognitive abilities of the offspring. While the offspring of mothers with gestational diabetes show alterations in prenatal neurodevelopment, explicit memory [11], as well as electrophysiological alterations related attention deficit [12], and motor alterations [13].…”