Department of Endocrinology and Internal Medicine, Department of Molecular Medicine, Aarhus University Hospital, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
Department of Gynecology and Obstetrics, Nordsjaellands Hospital, Hilleroed, Denmark.
Diabetes Care. 2015 Jul;38(7):1238-44. doi: 10.2337/dc15-0223. Epub 2015 Jun 12.
This study examined the effect of maternal pregestational type 1 diabetes on offspring primary school performance.
We performed a prospective combined clinical and register-based cohort study comparing primary school performance in offspring (n = 707) of women with pregestational type 1 diabetes with matched control offspring (n = 60,341). We also examined the association between HbA1c levels during pregnancy and later school performance among offspring born to women with pregestational type 1 diabetes.
Offspring of mothers with pregestational type 1 diabetes obtained similar school grades as control offspring when finishing primary school (regression coefficient [β] = -0.13; 95% CI = -0.30 to 0.03; P = 0.12). Adjusting for parental education also resulted in an insignificant difference between the two groups (β = -0.07; 95% CI = -0.23 to 0.09; P = 0.37). Among offspring of women with type 1 diabetes, increasing maternal HbA1c pregestationally and throughout the pregnancy was associated with lower average school grades. Offspring born to mothers with good glycemic control in the third trimester obtained higher average school grades compared with control offspring. The opposite applied to offspring born to mothers with inadequate glycemic control, who obtained significantly lower average school grades compared with control offspring.
Offspring of mothers with pregestational type 1 diabetes obtained similar average grades when finishing primary school compared with matched control offspring. Among offspring of women with type 1 diabetes, we found a consistent negative association between maternal HbA1c in pregnancy and primary school grades. However, whether this association reflects a direct causal influence of intrauterine hyperglycemia is uncertain.
本研究旨在探讨母亲妊娠前 1 型糖尿病对后代小学生学业成绩的影响。
我们进行了一项前瞻性的临床与基于登记的队列研究，比较了妊娠前患有 1 型糖尿病的女性的子女（n = 707）与匹配的对照组子女（n = 60,341）的小学生学业成绩。我们还研究了妊娠期间母亲的 HbA1c 水平与妊娠前患有 1 型糖尿病的女性所生孩子的后期学校表现之间的关系。
当完成小学学业时，患有妊娠前 1 型糖尿病的母亲的子女与对照组子女获得相似的学校成绩（回归系数 [β] = -0.13；95%CI = -0.30 至 0.03；P = 0.12）。调整父母教育水平后，两组之间也没有显著差异（β = -0.07；95%CI = -0.23 至 0.09；P = 0.37）。在 1 型糖尿病女性的子女中，母亲妊娠前和整个妊娠期间的 HbA1c 升高与较低的平均学校成绩相关。与对照组子女相比，在妊娠晚期血糖控制良好的母亲所生的子女获得较高的平均学校成绩。相反，血糖控制不佳的母亲所生的子女获得的平均学校成绩明显低于对照组子女。
与匹配的对照组子女相比，妊娠前患有 1 型糖尿病的母亲的子女在完成小学学业时获得相似的平均成绩。在 1 型糖尿病女性的子女中，我们发现母亲妊娠期间的 HbA1c 与小学成绩之间存在一致的负相关。然而，这种关联是否反映了宫内高血糖的直接因果影响尚不确定。
