Research Links Gestational Diabetes to Autism and ADHD Risks

A recent meta-analysis has identified concerning long-term consequences of gestational diabetes on both maternal health and child development. This condition, which develops during pregnancy, has been linked to a higher risk of cognitive dysfunction in mothers and developmental disorders in their children, including attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD). The findings will be presented at the Annual Meeting of the European Association for the Study of Diabetes (EASD) in Vienna next week.

The study, which synthesized data from nearly 50 scientific studies involving over nine million pregnancies across 20 countries, indicates that women who develop gestational diabetes during pregnancy show measurable declines in cognitive function. This research is especially critical as gestational diabetes affects approximately 14 percent of pregnancies worldwide and is becoming increasingly prevalent, particularly among older women, those with obesity, or individuals with a family history of diabetes.

The analysis examined 48 observational studies published up to April 2024. The research team focused on five studies assessing cognitive function in women during pregnancy. They found that mothers with gestational diabetes scored, on average, 2.47 points lower on the Montreal Cognitive Assessment, a screening tool for mild cognitive impairment, compared to those without the condition.

For children, the results were even more alarming. Data from 43 studies revealed that children exposed to gestational diabetes in utero had lower IQ scores by nearly 4 points on average than their peers. Furthermore, verbal crystallized intelligence, which encompasses language comprehension and communication skills, was reduced by just over 3 points. The research also identified significant associations with developmental disorders, showing that children born to mothers with gestational diabetes had a 45 percent higher risk of developmental delays, a 36 percent increased likelihood of ADHD, and a staggering 56 percent greater risk of autism spectrum disorder.

The exact mechanisms by which gestational diabetes affects cognitive and developmental outcomes remain unclear. Researchers suggest that chronic inflammation, oxidative stress, reduced oxygen supply, and elevated insulin levels during pregnancy may disrupt the normal development of the brain in utero. These biological stressors could manifest later as challenges in learning, attention, and social communication.

Professor Ling-Jun Li, the study’s lead author from the National University of Singapore’s School of Medicine, emphasized the importance of monitoring both maternal and child health. “Our findings underscore the urgency of addressing this significant public health concern that poses substantial cognitive dysfunction risks for both mothers and offspring,” she said.

Li further advised women diagnosed with gestational diabetes to prioritize their health during pregnancy and to monitor their children’s developmental milestones post-birth. She noted, “The evidence on postpartum neurocognitive function is still lacking, so we are unable to draw conclusions at this stage.”

For women at risk of developing gestational diabetes but not yet diagnosed, Dr. Li recommended vigilant monitoring of blood sugar under medical supervision, alongside a healthy antenatal diet and lifestyle. Current clinical trials are exploring strategies for optimal glycemic control in gestational diabetes, yielding promising short-term results for maternal and neonatal health.

Nevertheless, Dr. Li cautioned that evidence regarding long-term neurodevelopmental conditions like ADHD and autism is still limited. “We will need to await results from longer follow-up randomized controlled trials to confirm whether these approaches yield benefits in that domain,” she stated.

As research continues to unfold, the implications of gestational diabetes highlight a pressing need for enhanced awareness and management strategies to protect both maternal and child health.