A condition suffered by more than 330,000 pregnant women has been linked to a higher risk of autism.
Gestational diabetes, which affects around nine percent of American pregnant women, is on the rise, a trend driven by the same forces behind the broader diabetes epidemic, including older maternal age and rising obesity rates.
The upward trend is driven largely by the same forces behind the broader diabetes epidemic, including older maternal age and rising rates of obesity.
As more women enter pregnancy with these risk factors, their bodies struggle to manage the increased insulin needed during pregnancy, which carries lasting health implications for both mother and child.
Now, researchers from Australia and Singapore have learned that women with high blood sugar while pregnant scored several points lower on a cognitive test used to screen for dementia, and their children were more likely to achieve lower scores on IQ tests while facing a higher risk for total and partial developmental delays and attention-deficit/hyperactivity disorder (ADHD).
Researchers think gestational diabetes disrupts the fundamental, delicate processes of brain formation through inflammation, stress and nutrient imbalances, which then leads to differences in cognitive ability and a higher risk for neurodevelopmental disorders like ADHD and autism spectrum disorder (ASD).
Dr Ling-Jun Li, lead author and assistant professor from the School of Medicine, National University of Singapore, said: ‘There are increasing concerns about the neurotoxic effects of gestational diabetes on the developing brain.
‘Our findings underscore the urgency of addressing this significant public health concern that poses substantial cognitive dysfunction risks for both mothers and offspring.’
Researchers behind the new study conducted a systematic review of observational studies through April 2024 to assess the neurocognitive effects of gestational diabetes.
The analysis, encompassing data from over 9 million pregnancies globally, revealed that the condition is associated with significant cognitive deficits in children.
The meta-analysis found that children born to mothers with gestational diabetes exhibited statistically significant decreases in cognitive scores.
Specifically, their overall IQ scores were an average of about four points lower than those of children not exposed to the condition. Furthermore, these children showed a notable reduction in verbal crystallized intelligence, including smaller vocabularies and weaker verbal reasoning, with scores averaging more than three points lower.
Additionally, the study identified significantly higher risks for several neurodevelopmental disorders in children whose mothers had gestational diabetes.
These children faced a 45 percent higher risk for both total and partial developmental delays.
Furthermore, they were 36 percent more likely to be diagnosed with ADHD and had a 56 percent increased risk for ASD compared to children whose mothers did not have gestational diabetes.
While the exact link remains unclear, scientists suggested that gestational diabetes may influence a child’s brain development through several key mechanisms.
Factors like heightened inflammation, cellular stress, reduced oxygen supply, and elevated insulin levels in the womb can potentially alter how the fetal brain develops.
These changes are thought to lay the groundwork for the differences in learning and cognitive abilities seen later in childhood.
The study is being presented at this year’s Annual Meeting of The European Association for the Study of Diabetes (EASD) in Vienna, Austria.
Gestational diabetes mellitus (GDM) usually occurs in the second and third trimesters of pregnancy.
The exact cause of GDM is unclear, but researchers have found that hormones produced by the placenta, which support the baby’s growth, can sometimes block the mother’s insulin.
This causes the body to become less responsive to insulin, a state known as insulin resistance.
The mother’s body is then unable to use insulin effectively, requiring it to produce more. If it cannot produce enough insulin during pregnancy, glucose remains in the blood, leading to high blood sugar.
While GDM is treatable and generally goes away after pregnancy, it can pose health risks to both the mother and her baby if left unmanaged. Pregnant women with the condition should follow a healthy eating plan and be physically active.
Because it is such a stealthy condition with no obvious symptoms, doctors proactively screen for it. The standard method is a two-part ‘glucose challenge.’
Around weeks 24 to 28 of pregnancy, every expectant mother is asked to drink a sweet sugar solution.
An hour later, her blood is drawn. If her sugar levels are too high, it doesn’t mean she has GDM, but it flags her for the definitive follow-up test.
This second test is the real decider. After fasting overnight, the expectant mother drinks an even sweeter solution and has her blood tested multiple times over a few hours.
If her body struggles to process that sugar surge on two or more of those tests, she receives a diagnosis.
The process allows doctors to identify the condition and start management long before it can cause complications, turning a silent risk into a manageable part of prenatal care.
A woman is more likely to develop gestational diabetes if she has certain risk factors, such as having had it in a previous pregnancy, previously delivering a large baby over nine pounds, being overweight or having a family history of type 2 diabetes.
Other factors that increase risk include having polycystic ovary syndrome (PCOS) or being of African American, Hispanic, Native American, Alaska Native, Native Hawaiian, or Pacific Islander descent.
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