Diabetes in pregnancy is associated with an increased risk of autism and attention deficit hyperactivity disorder (ADHD), a large meta-analysis has suggested.
A Chinese study published in The Lancet Diabetes and Endocrinology looked at data from 202 observational studies with over 56 million pairs of mothers and children.
After taking into account factors that might skew the results, including obesity and socioeconomic status, the analysis showed that children of mothers who had diabetes in pregnancy had a 28% increased risk of neurodevelopmental disorder, compared to children of mothers without diabetes.
In relation to specific disorders, the data suggested children of mothers with maternal diabetes had a 25% increased risk of autism spectrum disorder, a 30% increased risk of ADHD, and a 32% increased risk of intellectual disability, compared to children whose mother did not have diabetes.
Risks were higher in women who had diabetes before pregnancy compared to women who developed gestational diabetes.
The results show the importance of ‘diligent monitoring of maternal glycaemic concentrations throughout pregnancy’, the researchers concluded.
As there is still currently little evidence of a causal link, more research is needed on the reasons for the association, they added.
‘By highlighting these associations, we aim to raise awareness and encourage holistic actions from clinicians, policymakers, and researchers, thereby improving health outcomes for both mothers and their children,’ they said.
The study said: ‘Maternal diabetes is associated with an increased risk of neurodevelopmental disorders and impaired neurodevelopmental performance in children.
‘Further high-quality research is needed to establish causality and clarify the associations between specific types of diabetes and the full spectrum of neurodevelopmental disorders.’
Professor Lucilla Poston, professor of maternal and fetal health at King’s College London, said the review had found that a range of neurodevelopmental disorders were strongly linked to pre-existing maternal type 1 diabetes, type 2 diabetes and also, but less so, to gestational diabetes.
The results were observational, and interpretation may be complicated by effects of diabetes treatment, and differences around the world in the diagnosis of gestational diabetes, she explained.
She added: ‘However, other evidence does imply causality, including many studies in experimental animals.
‘Also, data is emerging from MRI imaging of the brains of children exposed to maternal diabetes, showing structural and functional changes in the hypothalamus, a region of the brain intricately involved in both mental and physical health.
‘For this and other reasons, diabetes prevention, screening and treatment remain critically important not only for the health of the mother, but also her child.’
All autoimmune conditions in the mother are associated with higher rates of ADHD ( and this ASD). I’ve just been to a conference about it. There is probably a bi- directional relationship between so if you improve one you improve the other. There is an argument to screen all patients with an autoimmune disease for ADHD.