Diabetes in Pregnancy Raises ADHD Risk in Kids
Published: January 03, 2012
Children whose mothers developed gestational diabetes are at an increased risk for attention deficit hyperactivity disorder (ADHD) at age 6, especially if they are from families with low socioeconomic status, researchers found.
Maternal gestational diabetes was associated with a two-fold increase in ADHD risk by the time the child is 6 (OR 2.20, 95% CI 1 to 4.82, P=0.05), according to Yoko Nomura, PhD, of Queens College in Flushing, N.Y., and colleagues.
But the risk rose more than 14-fold for children of affected mothers when the family lived in low socioeconomic conditions (OR 14.31, 95% CI 2.14 to 95.88, P=0.006), the researchers reported online in Archives of Pediatric and Adolescent Medicine.
Gestational diabetes arises at a time of critical brain development in the fetus, but little is known about the long-term consequences of this on the child’s later neurologic and behavioral development.
To explore these concerns and to see if socioeconomic status conferred additional risk, Nomura and colleagues analyzed data from an ongoing cohort study of 212 children, who were enrolled at around 4 years of age. The cohort was largely middle class, ethnically diverse, and predominantly male.
A total of 10% of the mothers reported having developed gestational diabetes while pregnant with the child enrolled in the study.
At baseline, the mean inattention scores were higher for children whose mothers had gestational diabetes (12.25 versus 9.50, P=0.05), although differences were not seen for hyperactivity/impulsivity scores (12.58 versus 11.29, P=0.36).
But in children of low socioeconomic status, both inattention and hyperactivity scores were higher (11.96 versus 9.79, P=0.01, and 13.23 versus 10.65, P=0.01).
Low socioeconomic status alone was associated with a two-fold increase in ADHD risk both at baseline (OR 1.87, 95% CI 1.21 to 2.89, P=0.005) and at 6 years (OR 2.41, 95% CI 1.53 to 3.79, P0.001).
The researchers then compared development in children who were exposed to both maternal diabetes and low socioeconomic status, those exposed to diabetes alone, those exposed to low socioeconomic status alone, or neither.
They found that on neuropsychological function testing at baseline, children with both exposures fared worse in language (P0.001), memory (P=0.005), and visuospatial function (P=0.001).
They also had worse scores for inhibition (P0.001), levels of activity (P=0.04), persistence (P0.001), and impulsivity (P=0.003).
By age 6, children with both exposures were less adaptable (P=0.04), had poorer functional communication (P=0.009), greater attention difficulties (P=0.004), were more withdrawn (P=0.05), and more depressed (P=0.03).
When children with only one exposure were compared with those having neither exposure, no increased risk for ADHD at age 6 was seen.
But the increased risk seen for those with both exposures was “substantial,” and a statistical test determined that 82% of this risk could be attributed to the synergistic effects of maternal gestational diabetes and low socioeconomic status, the researchers explained.
Precisely how these factors interact is not known. However, “practitioners in internal medicine, endocrinology, obstetrics, and pediatrics should be alerted so that there can be multiple points of intervention to prevent the development of neuropsychological dysfunction in offspring,” they cautioned.
They also noted that ADHD has a strong genetic — and therefore not modifiable — component, which further heightens the importance of minimizing potentially modifiable environmental factors.
“It is clear that developing a refined understanding is urgently needed among expectant mothers regarding certain risk-prone behaviors (overeating, poor diet, and smoking during pregnancy) to mitigate the long-term human and economic costs,” they stated.
Limitations of the study included reliance on maternal reports of diabetes history about four years after delivery and a lack of information on family history of ADHD. Also, the analysis did not include a measure of the serum glucose level, which is predictive of the risk for developmental problems, including ADHD.
In addition, mothers with gestational diabetes were significantly older and had a greater number of ADHD symptoms themselves than those without gestational diabetes.
The authors had no financial disclosures.
Article source: http://www.medpagetoday.com/Pediatrics/ADHD-ADD/30480
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Jennifer Lee
16. Jan, 2012
Dear Celebritieswithdiseases,
Thanks for the above, i always keep hearing how frequent diabetes is permanently–but then you listen to about gestational diabetes–and how all the things goes again to typical when the pregnancy—wouldn’t that suggest that there could or must be a overcome for usual diabetes as well? or is gestational “diabetes” not honestly diabetes but just elevated blood glucose? but they you should not spike once consuming carbs?
just curious-tx for any options!
Keep up the good work
Jennifer Lee
15. Jan, 2012
G’Day! Celebritieswithdiseases,
Thanks for the info, There is an epidemic of diabetes in the United States. In the last ten years, the number of American diagnosed with diabetes has increased 40 percent. The number has risen from 4.9% to 6.9%. It is estimated that the number will increase buy another 16.5% by 2050. A woman born in 2000 has a 39% risk of developing diabetes. The epidemic of obesity is responsible for the current epidemic of diabetes in pregnancy. The incidence of diabetes complicating pregnancy has increased 40% between 1989 and 2004.
Cheerio