Fertility Department, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
Department of Economics and Business Economics, Aarhus University, Aarhus, Denmark.
PLoS Med. 2022 Apr 26;19(4):e1003977. doi: 10.1371/journal.pmed.1003977. eCollection 2022 Apr.
Conflicting results have been reported concerning possible adverse effects on the cognitive function of offspring of mothers with type 1 diabetes (O-mT1D). Previous studies have included offspring of parents from the background population (O-BP), but not offspring of fathers with type 1 diabetes (O-fT1D) as the unexposed reference group.
This is a population-based retrospective cohort study from 2010 to 2016. Nationally standardized school test scores (range, 1 to 100) were obtained for public school grades 2, 3, 4, 6, and 8 in O-mT1D and compared with those in O-fT1D and O-BP. Of the 622,073 included children, 2,144 were O-mT1D, and 3,474 were O-fT1D. Multiple linear regression models were used to compare outcomes, including the covariates offspring with type 1 diabetes, parity, number of siblings, offspring sex, smoking during pregnancy, parental age, and socioeconomic factors. Mean test scores were 54.2 (standard deviation, SD 24.8) in O-mT1D, 54.4 (SD 24.8) in O-fT1D, and 56.4 (SD 24.7) in O-BP. In adjusted analyses, the mean differences in test scores were -1.59 (95% CI -2.48 to -0.71, p < 0.001) between O-mT1D and O-BP and -0.78 (95% CI -1.48 to -0.08, p = 0.03) between O-fT1D and O-BP. No significant difference in the adjusted mean test scores was found between O-mT1D and O-fT1D (p = 0.16). The study's limitation was no access to measures of glycemic control during pregnancy.
O-mT1D achieved lower test scores than O-BP but similar test scores compared with O-fT1D. Glycemic control during pregnancy is essential to prevent various adverse pregnancy outcomes in women with type 1 diabetes. However, the present study reduces previous concerns regarding adverse effects of in utero hyperglycemia on offspring cognitive function.
关于 1 型糖尿病（O-mT1D）母亲的后代认知功能可能受到的不良影响，已有相互矛盾的研究结果。之前的研究纳入了来自背景人群父母的后代（O-BP），但没有纳入 1 型糖尿病父亲的后代（O-fT1D）作为未暴露的参照组。
这是一项基于人群的回顾性队列研究，时间范围为 2010 年至 2016 年。获取了 O-mT1D 及 O-fT1D 和 O-BP 公立学校 2、3、4、6 和 8 年级全国标准化学校考试成绩（范围为 1 至 100），并与这些成绩进行了比较。在纳入的 622073 名儿童中，2144 名为 O-mT1D，3474 名为 O-fT1D。使用多元线性回归模型比较了包括后代患有 1 型糖尿病、产次、兄弟姐妹数量、后代性别、孕期吸烟、父母年龄和社会经济因素在内的结果。O-mT1D 的平均测试分数为 54.2（标准差 24.8），O-fT1D 为 54.4（标准差 24.8），O-BP 为 56.4（标准差 24.7）。在调整分析中，O-mT1D 与 O-BP 之间的测试分数差值为-1.59（95%CI -2.48 至 -0.71，p < 0.001），O-fT1D 与 O-BP 之间为-0.78（95%CI -1.48 至 -0.08，p = 0.03）。O-mT1D 与 O-fT1D 之间的调整后平均测试分数差异无统计学意义（p = 0.16）。该研究的局限性在于无法获得妊娠期间血糖控制的测量值。
O-mT1D 的测试分数低于 O-BP，但与 O-fT1D 相似。妊娠期间的血糖控制对于预防 1 型糖尿病女性的各种不良妊娠结局至关重要。然而，本研究减轻了之前对宫内高血糖对后代认知功能的不良影响的担忧。
