In the Journals

Maternal diabetes, obesity increases risk of children's psychiatric disorders

Pregestational diabetes mellitus combined with severe maternal obesity was associated with risk for children’s psychiatric and mild neurodevelopmental disorders, compared with diabetes or obesity separately, according to study results published in Pediatrics.

“Prenatal exposure to obesity-related metabolic disturbances is associated not only with increased risk of metabolic dysfunction in the offspring but also an increased risk of offspring neurodevelopmental impairment and psychiatric disorders, specifically decreased cognitive performance, autism spectrum disorder (ASD) and ADHD,” the researchers wrote. “Authors of studies have suggested that maternal diabetes is also associated with an increased rate of learning difficulties, ASD, and possibly also ADHD in offspring.”

The researchers used nationwide registry data of all live births in Finland from 2004 and 2014 (n = 649,043). They estimated the effects of maternal obesity, pregestational diabetes mellitus (PGDM), and gestational diabetes mellitus (GDM) and their joint effects by measuring outcomes of psychiatric and mild neurodevelopmental diagnoses and prescription of psychotropic drugs among offspring.

Prepregnancy BMI was normal in 59.2% of the births, whereas 20.7% of mothers had overweight, 7.67% had obesity and 3.66% had severe obesity. In the study, 0.62% of mothers had PGDM and 15.7% had GDM.  Also, 5.4% of the children aged 11 years and younger were diagnosed with psychiatric disorder during the study period.

In comparison to mothers with normal BMI, the mothers without diabetes who were severely obese had a 67% to 88% increased risk of having a child with mild neurodevelopment disorders (HR = 1.69; 05% CI, 1.54-1.86), ADHD or conduct disorder (HR = 1.88; 95% CI, 1.58-2.23) and psychotic, mood and stress-related disorders (HR = 1.67; 95% CI, 1.31-2.13).  Mothers who were severely obese with PGDM were associated with a greater risk for all groups of having children develop psychiatric diagnosis originating in childhood or adolescence.  ASD (HR = 6.49; 95% CI, 3.08-13.69), ADHD and conduct disorder (HR = 6.03; 95% CI, 3.23-11.24) and mixed disorders of conduct and emotion (HR = 4.29; 95% CI, 2.14-8.60). The offspring disorders were not associated with a significantly increased risk in mothers with GDM.

“This is the first study used to explore a joint effect of maternal obesity and diabetes, stratified in PGDM and GDM, on the risk of a wide spectrum of psychiatric and neurodevelopmental disorders in offspring,” the researcher wrote. “We demonstrate that maternal prepregnancy obesity was associated with a slightly increased risk of offspring’s psychiatric and mild neurodevelopmental disorders, but the risk effects were most pronounced when mothers had both maternal PGSM and severe obesity.”

They concluded that further studies are required to determine biological connections between maternal diabetes and obesity and the long-term mental and behavioral health of offspring. – by Bruce Thiel

Disclosures:  The authors report no relevant financial disclosures.

Pregestational diabetes mellitus combined with severe maternal obesity was associated with risk for children’s psychiatric and mild neurodevelopmental disorders, compared with diabetes or obesity separately, according to study results published in Pediatrics.

“Prenatal exposure to obesity-related metabolic disturbances is associated not only with increased risk of metabolic dysfunction in the offspring but also an increased risk of offspring neurodevelopmental impairment and psychiatric disorders, specifically decreased cognitive performance, autism spectrum disorder (ASD) and ADHD,” the researchers wrote. “Authors of studies have suggested that maternal diabetes is also associated with an increased rate of learning difficulties, ASD, and possibly also ADHD in offspring.”

The researchers used nationwide registry data of all live births in Finland from 2004 and 2014 (n = 649,043). They estimated the effects of maternal obesity, pregestational diabetes mellitus (PGDM), and gestational diabetes mellitus (GDM) and their joint effects by measuring outcomes of psychiatric and mild neurodevelopmental diagnoses and prescription of psychotropic drugs among offspring.

Prepregnancy BMI was normal in 59.2% of the births, whereas 20.7% of mothers had overweight, 7.67% had obesity and 3.66% had severe obesity. In the study, 0.62% of mothers had PGDM and 15.7% had GDM.  Also, 5.4% of the children aged 11 years and younger were diagnosed with psychiatric disorder during the study period.

In comparison to mothers with normal BMI, the mothers without diabetes who were severely obese had a 67% to 88% increased risk of having a child with mild neurodevelopment disorders (HR = 1.69; 05% CI, 1.54-1.86), ADHD or conduct disorder (HR = 1.88; 95% CI, 1.58-2.23) and psychotic, mood and stress-related disorders (HR = 1.67; 95% CI, 1.31-2.13).  Mothers who were severely obese with PGDM were associated with a greater risk for all groups of having children develop psychiatric diagnosis originating in childhood or adolescence.  ASD (HR = 6.49; 95% CI, 3.08-13.69), ADHD and conduct disorder (HR = 6.03; 95% CI, 3.23-11.24) and mixed disorders of conduct and emotion (HR = 4.29; 95% CI, 2.14-8.60). The offspring disorders were not associated with a significantly increased risk in mothers with GDM.

“This is the first study used to explore a joint effect of maternal obesity and diabetes, stratified in PGDM and GDM, on the risk of a wide spectrum of psychiatric and neurodevelopmental disorders in offspring,” the researcher wrote. “We demonstrate that maternal prepregnancy obesity was associated with a slightly increased risk of offspring’s psychiatric and mild neurodevelopmental disorders, but the risk effects were most pronounced when mothers had both maternal PGSM and severe obesity.”

They concluded that further studies are required to determine biological connections between maternal diabetes and obesity and the long-term mental and behavioral health of offspring. – by Bruce Thiel

Disclosures:  The authors report no relevant financial disclosures.