February 01, 2012
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Gestational diabetes linked to heightened risk for ADHD

Nomura Y. Arch Pediatr Adolesc Med. 2012;doi:10.1001/archpediatrics.2011.784.

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Children whose parents fall into a lower socioeconomic status and are exposed to maternal gestational diabetes may have as much as a 14-fold increased risk for developing attention-deficit/hyperactivity disorder, according to study results published online.

Yoko Nomura, MD, PhD, of Queens College, City University of New York, and colleagues distributed the ADHD Rating Scale-IV to parents of 3- and 4-year-old children in preschools surrounding Queens College and recruited 212 participants at a 2:1 ratio of “at-risk” to “typically developing” children. At-risk children had at least six inattention or six hyperactive and impulsive symptoms as rated by parents, teachers or both. Typically developing children had fewer than three symptoms in each domain.

The average inattention score at baseline for offspring born to mothers with gestational diabetes was significantly higher than for offspring unexposed, but there was no difference in hyperactivity/impulsivity scores between the two groups. Children in low socioeconomic status families had greater inattention and hyperactivity/impulsivity scores vs. high socioeconomic status families. The results showed no difference in the risk for ADHD at baseline, but a twofold increased risk at age 6 years among children exposed to gestational diabetes vs. children who were not exposed. There was also a twofold increased risk for ADHD at baseline and at age 6 years among children in low socioeconomic status families.

Children exposed to gestational diabetes and low socioeconomic status showed compromised neurobehavioral functioning, including lower IQ, poorer language abilities and diminished behavioral and emotional functioning, and a 14-fold increased risk for developing ADHD. Conversely, children exposed to maternal gestational diabetes alone or low socioeconomic status alone had no significant increased risk for ADHD.

“Most of the relevant environmental risks are presumed to occur very early in development,” Joel Nigg, PhD, of Oregon Health & Science University, said in an accompanying editorial. “If causal, and if able to be understood pathophysiologically, such environmental effects on ADHD are of ‘game-changing’ importance because they open the door to eventually preventing that portion of cases of ADHD caused by early insult to the nervous system.”

Disclosure: The researchers report no relevant financial disclosures.

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