Damtie Yitayish, Betts Kim, Dachew Berihun Assefa, Ayano Getinet, Alati Rosa
School of Population Health, Faculty of Health Sciences, Curtin University, Australia; Department of Public Health, College of Medicine and Health Science, Injibara University, Injibara, Ethiopia.
School of Population Health, Faculty of Health Sciences, Curtin University, Australia.
J Psychosom Res. 2025 Aug;195:112167. doi: 10.1016/j.jpsychores.2025.112167. Epub 2025 May 27.
Limited evidence exists on the association between maternal use of antidiabetic medications and neurodevelopmental outcomes in children. This study examined the link between maternal diabetes, antidiabetic medication use, and the risk of severe Attention-deficit/hyperactivity disorder (ADHD) requiring inpatient care.
The study analysed routinely collected linked health administrative data from New South Wales, Australia. Maternal diabetes, antidiabetic medication use, and offspring ADHD diagnoses were identified using ICD-10-AM codes. Binary logistic regression was fitted to estimate associations, with results reported as adjusted odds ratios (AOR) and 95 % confidence intervals (CI).
A total of 229,785 mother-offspring pairs were included in the final analysis. After adjusting for potential confounders, intrauterine exposure to any form of maternal diabetes diagnosed during pregnancy, including gestational diabetes (GDM) and pre-existing diabetes, was not associated with an increased risk of severe ADHD in offspring (any diabetes: AOR = 1.10, 95 % CI: 0.84-1.45; GDM: AOR = 1.12, 95 % CI: 0.84-1.49; pre-existing diabetes: AOR = 1.29, 95 % CI: 0.53-3.14). Similarly, the use of antidiabetic medications during pregnancy was not linked with ADHD in children (OR = 1.17, 95 % CI: 0.66-2.06).
Our finding did not support the hypothesis that prenatal exposure to antidiabetic medications independently increases the risk of severe ADHD in children. Given the limited existing evidence, further research is warranted to better understand the long-term neurodevelopmental safety of these medications.
关于母亲使用抗糖尿病药物与儿童神经发育结局之间的关联，现有证据有限。本研究调查了母亲患糖尿病、使用抗糖尿病药物与需要住院治疗的重度注意力缺陷多动障碍（ADHD）风险之间的联系。
该研究分析了从澳大利亚新南威尔士州常规收集的关联健康管理数据。使用ICD - 10 - AM编码识别母亲患糖尿病情况、抗糖尿病药物使用情况以及后代ADHD诊断情况。采用二元逻辑回归来估计关联，结果以调整后的优势比（AOR）和95%置信区间（CI）报告。
最终分析共纳入229,785对母婴。在对潜在混杂因素进行调整后，孕期宫内暴露于孕期诊断出的任何形式的母亲糖尿病，包括妊娠期糖尿病（GDM）和孕前糖尿病，与后代患重度ADHD的风险增加无关（任何糖尿病：AOR = 1.10，95%CI：0.84 - 1.45；GDM：AOR = 1.12，95%CI：0.84 - 1.49；孕前糖尿病：AOR = 1.29，95%CI：0.53 - 3.14）。同样，孕期使用抗糖尿病药物与儿童患ADHD无关（OR = 1.17，95%CI：0.66 - 2.06）。
我们的研究结果不支持产前暴露于抗糖尿病药物会独立增加儿童患重度ADHD风险的假设。鉴于现有证据有限，有必要进一步研究以更好地了解这些药物的长期神经发育安全性。
