Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA.
Department of Health Promotion and Disease Prevention, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA.
Child Neuropsychol. 2023 May;29(4):588-606. doi: 10.1080/09297049.2022.2103105. Epub 2022 Jul 22.
Little is known about the long-term effects of maternal diabetes during pregnancy (DP), either gestational diabetes or preexisting diabetes (type 1 or type 2), on offspring's brain morphometry and neurocognitive functioning (NCF). This study examined the effect of prenatal exposure to maternal DP on the brain structure and NCF in children between 9 and 10 years of age. This study used cross-sectional neuroimaging and NCF data from the baseline wave of the Adolescent Brain and Cognitive Development® study. Exposure to maternal DP was assigned from the developmental history questionnaire. Differences in the brain cortical thickness (CTh) and five cognitive abilities (executive function, working and episodic memory, processing speed, and language abilities) were examined in diabetes-exposed and diabetes-unexposed children. Linear mixed effect models and generalized linear models were used to adjust for the effect of confounding variables. A total of 9,967 children (718 diabetes-exposed and 9249 unexposed) were included in the analysis. Diabetes-exposed children had lower whole-brain CTh [mean: exposed vs unexposed = 2.725 mm vs 2.732 mm; difference (95%CI): -0.007 mm (-0.013, -0.001)] compared to unexposed children after adjusting for confounding variables. Diabetes-exposed children had lower CTh in most part of the occipital lobe of both hemispheres, right postcentral gyrus, and left superior parietal cortex. Diabetes-exposed children also had lower scores in processing speed task [mean difference (95%CI): -1.7 (-2.8, -0.6)] and total cognition [mean difference (95%CI): -0.6 (-1.2, -0.02)]. Diabetes-exposed children have reduced CTh and NCF during preadolescence, which might have implications for psychomotor development during later life. Prospective studies are needed to confirm our findings.
人们对妊娠期间（DP）母体糖尿病（无论是妊娠期糖尿病还是先前存在的 1 型或 2 型糖尿病）对后代大脑形态计量和神经认知功能（NCF）的长期影响知之甚少。本研究探讨了产前暴露于母体 DP 对 9 至 10 岁儿童大脑结构和 NCF 的影响。本研究使用了青少年大脑与认知发展研究的基线波的横断面神经影像学和 NCF 数据。母体 DP 的暴露情况是从发育史问卷中分配的。在患有糖尿病和未患有糖尿病的儿童中，检查了大脑皮质厚度（CTh）和五种认知能力（执行功能、工作和情景记忆、处理速度和语言能力）的差异。线性混合效应模型和广义线性模型用于调整混杂变量的影响。共有 9967 名儿童（718 名糖尿病暴露和 9249 名未暴露）纳入分析。在调整混杂变量后，与未暴露的儿童相比，糖尿病暴露的儿童的全脑 CTh 较低[平均值：暴露与未暴露=2.725mm vs 2.732mm；差异（95%CI）：-0.007mm（-0.013，-0.001）]。与未暴露的儿童相比，糖尿病暴露的儿童大脑左右半球的大部分枕叶、右侧中央后回和左侧顶叶上回的 CTh 均较低。糖尿病暴露的儿童在处理速度任务中的得分也较低[平均差异（95%CI）：-1.7（-2.8，-0.6）]和总认知[平均差异（95%CI）：-0.6（-1.2，-0.02）]。糖尿病暴露的儿童在青春期前大脑 CTh 和 NCF 降低，这可能对以后的生活中的精神运动发育有影响。需要前瞻性研究来证实我们的发现。
