Evidence shows that obesity-related complications in the mother can affect offspring's neurodevelopment. However, results of individual cohort studies have been inconsistent.
Aims: To investigate the association between gestational diabetes mellitus (GDM) with neurodevelopment, cognitive and behaviour outcomes in children.
Methods: Harmonised data ( >200 000 mother-child pairs) across ten birth cohorts in Europe and Australia were included where GDM was recorded (yes/no) and >neurodevelopmental, cognitive and behavioural outcome was available in children aged 3 -13. Confounder-adjusted regression models were used to estimate associations between maternal diabetes and child outcomes using individual participant data (IPD) meta-analysis. Estimates (model 1) included adjustments for child sex and maternal age. Full adjustment (model 2) included adjustment for child sex and maternal age, pre-pregnancy BMI, pregnancy weight gain, maternal smoking during pregnancy, plurality, parity, maternal education, and income.
Results: Children (aged 7-10 years) born to mothers with GDM had higher attention-deficient hyperactive disorder (ADHD) symptoms compared to non-exposed controls (model 2, regression coefficient (β) 2.40 (95% CI 0.07, 4.73), P=0.04). Moreover, children (aged 4-6 years) born to mothers with GDM exhibited more externalising problems than those born to mothers without GDM (model 2, β 2.50 (95% CI 0.15, 4.85), P=0.03). In the secondary analysis, maternal history of type 1 and type 2 diabetes mellitus was associated with ADHD symptoms at 4-6 years (model 1, β 8.82 (95% CI 2.21, 15.45, P=0.009) and β 7.90 (95% CI 0.82, 14.98, P=0.02), respectively). The association was no longer apparent in further adjustments.
Conclusions: Children between 4-6 and 7-10 years of age born to mothers with obesity-related complications of GDM have a greater likelihood of developing externalising problems and ADHD symptoms. Overall, this large-scale multi-cohort study suggested that a dysregulated metabolic environment during pregnancy related to maternal obesity may contribute to ADHD and externalising problems in children.