Gestational diabetes makes children more likely to be autistic

Wed, 15 Apr 2015
The children of mothers who experience gestational diabetes are more likely to be autistic, new research suggests.

The study, published in JAMA, is not the first to link gestational diabetes with health problems in children: Pregnant women who develop gestational diabetes are more likely to have children who are dangerously heavy (macrosomia); have low blood sugar levels (hypoglycemia); and have a higher risk of developing impaired glucose tolerance.

Moreover, children exposed to high blood glucose levels (hyperglycemia) in the womb are more likely to develop obesity and other metabolic disorders.

What is gestational diabetes?

Gestational diabetes is a form of diabetes that only affects pregnant women. During pregnancy, blood glucose levels are raised, which increases the demand on insulin. Sometimes insulin cannot regulate the elevated blood glucose levels.

Gestational diabetes is usually treated through careful management of diet and exercise. In some cases insulin injections might be required, but these instances are rare.

Gestational diabetes goes away after the baby is born, but it increases the mother's risk of developing type 2 diabetes later in life. And, according to some research, the baby's.

The study

The researchers examined the prevalence of autism spectrum disorders (ASD) among 322,323 children.

7.8 per cent of the children (25,035) were exposed to high blood glucose levels in the womb through gestational diabetes. Two per cent (6,496) were exposed to high blood glucose levels as a result of their mother's type 2 diabetes. 90.2 per cent of the children (290,792) were not exposed to high blood glucose levels in the womb.

3,388 children were diagnosed with an autism spectrum disorder. After adjusting the data to accommodate several factors (including household income, ethnicity, sex, and maternal age) the researchers concluded that exposure to high blood glucose levels in the womb through gestational diabetes was associated with an increased risk of autism spectrum disorders. Exposure to high blood glucose levels in the womb through other means, such as the mother's type 2 diabetes, did not increase the risk of autism spectrum disorders.

Other factors that did not increase the risk include mother's smoking status and pre-pregnancy body mass index (BMI).

The significance of the findings

The study had several limitations. The researchers did not evaluate risk factors that may come from the father (due to lack of data), and the research is unable to rule out several other factors that could have an influence, including the child's genetic predisposition to autism spectrum disorders.

"However, our results suggest that early screening for ASD in offspring of women with GDM diagnosed by 26 weeks' gestation may be warranted," the authors wrote.

"Our results also suggest that screening for GDM and control of glucose levels early in pregnancy may be important in reducing ASD risk for offspring."

"Meta-analyses have shown some evidence of a significant association between exposure to maternal diabetes and risk of ASD in offspring. Less information is available on the association of exposure to maternal GDM [...] with risk of ASD."
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