Gestational diabetes mellitus and children's social-emotional development, behavioral problems, and psychological adjustment.

BACKGROUND

This longitudinal cohort study investigated whether gestational diabetes mellitus (GDM) is associated with 2- and 5-year-old children's social-emotional development and whether child sex moderates the association.

METHODS

FinnBrain Birth Cohort Study recruited 3808 pregnant women 2011-2015 in Finnish Turku region and Åland Islands. Their children's social-emotional development at 2 years was measured by Brief Infant Toddler Social Emotional Assessment (BITSEA) (N = 1444, GDM n = 227) and at 5 years by Strengths and Difficulties Questionnaire (SDQ) (N = 1489, GDM n = 225). General linear models were used.

RESULTS

After adjusting for covariates, GDM was not associated with children's social-emotional development at age 2 years. At age 5, GDM was associated with greater total behavioral difficulties (p = 0.025, for 1-point increase in total score η = 0.004). Sex-stratified analyses showed GDM was associated with greater internalizing problems in girls at 2 years (p = 0.044, η = 0.007), and greater conduct problems (p = 0.018, η = 0.007), hyperactivity/inattention (p = 0.001, η = 0.014) and total difficulties (p < 0.001, η = 0.015) in boys at 5 years. Interaction of child's sex and GDM was observed for hyperactivity/inattention (p = 0.015) and total difficulties (p = 0.019) at 5 years.

CONCLUSION

GDM may influence children's social-emotional development, behavioral problems, and adjustment-and, furthermore, in a sexually dimorphic manner. Longer follow-up is needed to evaluate long-term stability of findings.

IMPACT

Gestational diabetes mellitus (GDM) was associated with greater total behavioral difficulties of offspring at the age of five. GDM was associated with greater internalizing problems in girls at 2 years GDM was associated with greater conduct problems, hyperactivity/inattention and total difficulties in boys at 5 years. GDM may influence children's social-emotional development in a sexually dimorphic manner. Findings call for further study of mechanisms of children's social-emotional development as well as shed light on GDM-related risk factors for early intervention.