Obesity, diabetes during pregnancy are tied to increased pediatric neurodevelopmental diagnoses

  • Kong L & al.
  • JAMA Netw Open
  • 5 Feb 2020

  • curated by Elisabeth Aron, MD, MPH, FACOG
  • Clinical Essentials
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Takeaway

  • High BMI and diabetes during pregnancy are linked to increased rates of pediatric neurodevelopmental and neuropsychiatric diagnoses.

Why this matters

  • Diabetes and obesity may affect neurodevelopment.

Key results

  • Higher maternal BMI with no diabetes was tied to increased risk (HRs) for neurodevelopmental and neuropsychiatric ICD codes in the children:
    • BMI ≥30 to 2: 1.30 (95% CI, 1.24-1.36). 
    • BMI ≥35 kg/m2: 1.43 (95% CI, 1.33-1.54).
  • Diabetes plus obesity added to the association (HRs) vs obesity only: 
    • Type 2 diabetes + BMI ≥35 kg/m2: 1.97 (95% CI, 1.64-2.37); 
    • Gestational diabetes + BMI ≥35 kg/m2: 1.61 (95% CI, 1.50-1.72).
  • The most common pediatric diagnoses were mood disorders, autism spectrum disorder, ADHD, and conduct disorders.

Study design

  • Population-based cohort study.
  • Cohort obtained from a nationwide registry in Finland, 2019.
  • Exposures included maternal prepregnancy BMI, insulin-treated pregestational diabetes, pregestational type 2 diabetes, and gestational diabetes.
  • Outcome measures included ICD neurodevelopmental and neuropsychiatric diagnoses and prescription of psychotropic drugs among 649,043 children resulting from these pregnancies.
  • Funding: THL National Institute for Health and Welfare, Drug and Pregnancy Project; Swedish Research Council; and China Scholarship Council.

Limitations

  • Information on blood glucose levels and preeclampsia not available.
  • Results show correlation, not causation.