China Center for Health Development Studies, Peking University, Beijing, China.
Department of Health Policy and Management, School of Public Health, Peking University, Beijing, China.
Paediatr Perinat Epidemiol. 2021 Jan;35(1):109-119. doi: 10.1111/ppe.12710. Epub 2020 Sep 3.
Maternal abnormal glucose tolerance during pregnancy may adversely affect offspring cognition and behaviour, but few prospective studies investigated this association at multiple points throughout childhood.
We hypothesised that maternal abnormal glucose tolerance is associated with child cognitive and behavioural outcomes in early and mid-childhood.
We examined the associations of maternal abnormal glucose tolerance at 26-28 weeks of pregnancy with offspring cognitive and behavioural scores in 1421 children in the Project Viva pre-birth cohort. In early (mean 3.3 years) and mid-childhood (mean 7.9 years), we measured child cognition using validated instruments, the Kaufman Brief Intelligence Test, Wide Range Assessment of Memory and Learning, and the Wide Range Assessment of Visual Motor Abilities (WRAVMA); we assessed parent- and teacher-rated behavioural outcomes with the Strengths and Difficulties Questionnaire and the Behavioural Rating Inventory of Executive Function. We used linear regression models adjusted for potential confounders (maternal race/ethnicity, pre-pregnancy BMI, intelligence, age, parity, smoking status, education, and household income at enrolment, in addition to child's sex and age at assessment).
Of 1421 mothers, 69 (4.9%) had gestational diabetes mellitus, 43 (3.0%) impaired glucose tolerance, 122 (8.6%) isolated hyperglycaemia, and 1187 (83.5%) normal glucose tolerance. Offspring born to women with gestational diabetes mellitus had lower total WRAVMA scores (-3.09 points; 95% CI -6.12, -0.05) in early childhood compared with offspring of women with normal glucose tolerance. None of the abnormal glucose tolerance categories during pregnancy were associated with any of the cognitive outcomes (verbal, non-verbal, and visual motor scores) or behavioural measures in mid-childhood.
Children born to mothers who had gestational diabetes mellitus had slightly lower scores on one cognitive test in early childhood. We found no evidence to support that maternal abnormal glucose tolerance was associated with cognitive or behavioural development in mid-childhood.
孕妇在怀孕期间的异常葡萄糖耐量可能会对后代的认知和行为产生不利影响，但很少有前瞻性研究在整个儿童期的多个时间点上对此关联进行调查。
我们假设，孕妇异常葡萄糖耐量与儿童在幼儿期和中期的认知和行为结果有关。
我们在 Viva 出生前队列的 1421 名儿童中，检查了孕妇在 26-28 周妊娠时的异常葡萄糖耐量与后代认知和行为评分之间的关联。在幼儿期（平均 3.3 岁）和中期（平均 7.9 岁），我们使用经过验证的工具，即 Kaufman 简明智力测验、广泛记忆和学习评估、以及广泛视觉运动能力评估（WRAVMA），测量儿童的认知能力；我们使用父母和教师评定的行为结果量表，即长处和困难问卷以及行为评定量表的执行功能。我们使用线性回归模型进行调整，以控制潜在的混杂因素（母亲的种族/民族、孕前 BMI、智力、年龄、产次、吸烟状况、教育程度和家庭收入，以及儿童的性别和评估时的年龄）。
在 1421 位母亲中，有 69 位（4.9%）患有妊娠期糖尿病，43 位（3.0%）患有葡萄糖耐量受损，122 位（8.6%）患有孤立性高血糖，1187 位（83.5%）患有正常葡萄糖耐量。与正常葡萄糖耐量母亲所生的后代相比，患有妊娠期糖尿病的母亲所生的后代在幼儿期的总 WRAVMA 评分较低（低 3.09 分；95%CI -6.12，-0.05）。妊娠期间的任何异常葡萄糖耐量类别与中期的任何认知结果（言语、非言语和视觉运动评分）或行为测量均无关联。
母亲患有妊娠期糖尿病的儿童在幼儿期的一项认知测试中得分略低。我们没有证据表明，孕妇异常葡萄糖耐量与儿童在中期的认知或行为发育有关。
