A review of 202 studies involving more than 56 million mother-child pairs has observed an association between maternal diabetes — including pre-pregnancy and gestational diabetes — and an increased risk of neurodevelopmental disorders in children, such as autism spectrum disorders, attention deficit hyperactivity disorder or intellectual disability. The authors, who publish the results in the journal The Lancet Diabetes & Endocrinology, call for a cautious interpretation of the association, as there is currently little evidence of a causal relationship.
Maia Brik - diabetes materna EN
Maia Brik
Specialist in obstetrics and maternal-fetal medicine at the Obstetrics Department of the Vall d'Hebron Hospital.
It is a systematic review and meta-analysis which, at the present time, is the type of study with the highest scientific quality that exists, together with the randomised clinical trial. The methodology it includes is adjusted to the objectives of the study. I consider it to be a study of good scientific quality.
The prognosis of the children of diabetic mothers has been studied in depth, but it is true that this study analyses a very large sample of diabetic women and their children in the long term, so the conclusions are more robust. It concludes that there is an association between gestational diabetes and neurodevelopmental disorders during childhood and up to the age of 18, which is a fairly long period. However, the existence of a relationship does not imply that it is the cause. It is known that neurodevelopment during childhood is subject to multiple factors, both biological and psychosocial. It is difficult to establish causality alone.
The implications of this article would be twofold: on the one hand, and fundamentally, the prevention of diabetes during pregnancy through physical activity (150 minutes of moderate activity per week, if there are no contraindications) and a good diet during pregnancy, and even before trying to conceive, as well as reducing obesity before and avoiding excessive weight gain during pregnancy. On the other hand, from the counselling and management of women diagnosed with diabetes during pregnancy.
[Regarding possible limitations] Although many of the studies included in the meta-analysis include several confounding factors, not all of them are found, so the conclusions may be biased.
On the other hand, it is difficult to establish causality between diabetes and neurodevelopmental disorders based on this study.
Finally, neurodevelopment over 18 years can be modulated by the environment, so there is no need to alert society, since diabetes has a prevalence of 8-9%. The brain of the baby and child and neurodevelopment is very plastic and modifiable depending on the environment, stimulation, etc.
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Ye et al.
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