The Iranian Journal of Obstetrics, Gynecology and Infertility

The Iranian Journal of Obstetrics, Gynecology and Infertility

Gestational diabetes and neurodevelopmental disorders in offspring: A systematic review

Document Type : Review Article

Authors
Marzieh Saei Ghare Naz 1
Fahimeh Ramezani Tehrani 2
1 PhD in Reproductive Health, Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences and Metabolism, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
2 Professor, Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences and Metabolism, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
10.22038/ijogi.2022.21382
Abstract
Introduction: Gestational diabetes (GDM) is one of the serious complications of pregnancy which can lead to adverse outcomes for mother and offspring in the short and long-term. This systematic review study was performed to investigate the relationship between GDM and neurodevelopmental disorders in the offspring.
Methods: In this review study, to find the related articles, databases of PubMed, Scopus, Web of Science, and Google Scholar were searched using the keywords of gestational diabetes, offspring, cognitive disorder and behavioral disorder up to March 2022. The Newcastle-Ottawa scale was used to assess the quality of the studies. The findings of this study were reported qualitatively.
Results: This study reviewed 14 observational studies with 728140 participants. The findings of included studies on the incident of neurodevelopmental complications in the offspring of mothers with GDM, who were diagnosed using different diagnostic criteria, show the possibility of neurodevelopmental complications in the offspring of mothers with GDM. The most common diagnosing criterion of GDM was the Carpenter-Coustan criterion; after that, the World Health Organization diagnostic criterion was the most common.
Conclusion: The available evidence mainly indicated the association between GDM and neurodevelopmental disorders in the offspring, while due to limited studies, it was not possible to compare the outcomes of different diagnostic and therapeutic approaches.
Keywords
Diagnostic criteria
Gestational diabetes
Neurocognitive development
Review
  1. Behboudi-Gandevani S, Amiri M, Bidhendi Yarandi R, Ramezani Tehrani F. The impact of diagnostic criteria for gestational diabetes on its prevalence: a systematic review and meta-analysis. Diabetology & metabolic syndrome 2019; 11(1):1-8.
  2. Al-Rifai RH, Abdo NM, Paulo MS, Saha S, Ahmed LA. Prevalence of Gestational Diabetes Mellitus in the Middle East and North Africa, 2000–2019: A Systematic Review, Meta-Analysis, and Meta-Regression. Frontiers in endocrinology 2021: 1010.
  3. Rahimi M, Karami Moghadam F. The prevalence of gestational diabetes mellitus and its related risk factors using one-step method in Kermanshah, 2016. Iran J Obstet Gynecol Infertil 2017; 20(4):1-4.
  4. Sayehmiri F, Bakhtiyari S, Darvishi P, Sayehmiri K. Prevalence of gestational diabetes mellitus in Iran: a systematic review and meta-analysis study. Iran J Obstet Gynecol Infertil 2013; 15(40):16-23.
  5. American Diabetes Association. 2. Classification and diagnosis of diabetes: Standards of Medical Care in Diabetes—2020. Diabetes care 2020; 43(Supplement_1):S14-31.
  6. Plows JF, Stanley JL, Baker PN, Reynolds CM, Vickers MH. The pathophysiology of gestational diabetes mellitus. International journal of molecular sciences 2018; 19(11):3342.
  7. Kiani F, Naz MS, Sayehmiri F, Sayehmiri K, Zali H. The risk factors of gestational diabetes mellitus: a systematic review and meta-analysis study. Diabetes 2017; 10:17.
  8. Garrison A. Screening, diagnosis, and management of gestational diabetes mellitus. American family physician 2015; 91(7):460-7.
  9. McIntyre HD, Catalano P, Zhang C, Desoye G, Mathiesen ER, Damm P. Gestational diabetes mellitus. Nature reviews Disease primers 2019; 5(1):1-19.
  10. Shou C, Wei YM, Wang C, Yang HX. Updates in long-term maternal and fetal adverse effects of gestational diabetes mellitus. Maternal-Fetal Medicine 2019; 1(02):91-4.
  11. Nomura Y, Marks DJ, Grossman B, Yoon M, Loudon H, Stone J, et al. Exposure to gestational diabetes mellitus and low socioeconomic status: effects on neurocognitive development and risk of attention-deficit/hyperactivity disorder in offspring. Archives of pediatrics & adolescent medicine 2012;166(4):337-43.
  12. Farahvar S, Walfisch A, Sheiner E. Gestational diabetes risk factors and long-term consequences for both mother and offspring: a literature review. Expert review of endocrinology & metabolism 2019; 14(1):63-74.
  13. Xu G, Jing J, Bowers K, Liu B, Bao W. Maternal diabetes and the risk of autism spectrum disorders in the offspring: a systematic review and meta-analysis. Journal of autism and developmental disorders 2014; 44(4):766-75.
  14. Rowland J, Wilson CA. The association between gestational diabetes and ASD and ADHD: a systematic review and meta-analysis. Scientific reports 2021; 11(1):1-16.
  15. Hami J, Shojae F, Vafaee-Nezhad S, Lotfi N, Kheradmand H, Haghir H. Some of the experimental and clinical aspects of the effects of the maternal diabetes on developing hippocampus. World journal of diabetes 2015; 6(3):412.
  16. Moon JH, Jang HC. Gestational diabetes mellitus: diagnostic approaches and maternal-offspring complications. Diabetes & Metabolism Journal 2022; 46(1):3-14.
  17. Rani PR, Begum J. Screening and diagnosis of gestational diabetes mellitus, where do we stand. Journal of clinical and diagnostic research: JCDR 2016; 10(4):QE01.
  18. Bhavadharini B, Uma R, Saravanan P, Mohan V. Screening and diagnosis of gestational diabetes mellitus–relevance to low and middle income countries. Clinical diabetes and endocrinology 2016; 2(1):1-8.
  19. Sandu C, Bica C, Salmen T, Stoica R, Bohiltea R, Gherghiceanu F, et al. Gestational diabetes‑modern management and therapeutic approach. Experimental and therapeutic medicine 2021; 21(1):1.
  20. Metzger BE, Coustan DR, Trimble ER. Hyperglycemia and adverse pregnancy outcomes. Clinical chemistry 2019; 65(7):937-8.
  21. Tehrani FR, Naz MS, Bidhendi-Yarandi R, Behboudi-Gandevani S. Effect of Different Types of Diagnostic Criteria for Gestational Diabetes Mellitus on Adverse Neonatal Outcomes: A Systematic Review, Meta-Analysis, and Meta-Regression. Korean Diabetes Journal 2022.
  22. Ramezani Tehrani F, Naz MS, Yarandi RB, Behboudi-Gandevani S. The impact of diagnostic criteria for gestational diabetes mellitus on adverse maternal outcomes: a systematic review and meta-analysis. Journal of clinical medicine 2021; 10(4):666.
  23. Moher D, Liberati A, Tetzlaff J, Altman DG; PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Int J Surg 2010; 8(5):336-41.
  24. Herzog R, Álvarez-Pasquin M, Díaz C, Del Barrio JL, Estrada JM, Gil Á. Are healthcare workers’ intentions to vaccinate related to their knowledge, beliefs and attitudes? A systematic review. BMC public health 2013; 13(1):1-17.
  25. Luchini C, Stubbs B, Solmi M, Veronese N. Assessing the quality of studies in meta-analyses: Advantages and limitations of the Newcastle Ottawa Scale. World J Meta-Anal 2017; 5(4):80-4.
  26. Akaltun İ, Yapça ÖE, Ayaydin H, Kara T. An evaluation of attention deficit hyperactivity disorder and specific learning disorder in children born to diabetic gravidas: A case control study. Anadolu Psikiyatr De 2019; 20(10.5455).
  27. Daraki V, Roumeliotaki T, Koutra K, Georgiou V, Kampouri M, Kyriklaki A, et al. Effect of parental obesity and gestational diabetes on child neuropsychological and behavioral development at 4 years of age: the Rhea mother–child cohort, Crete, Greece. European child & adolescent psychiatry 2017; 26(6):703-14.
  28. Ornoy A, Wolf A, Ratzon N, Greenbaum C, Dulitzky M. Neurodevelopmental outcome at early school age of children born to mothers with gestational diabetes. Archives of Disease in Childhood-Fetal and Neonatal Edition 1999; 81(1):F10-4.
  29. Veena SR, Krishnaveni GV, Srinivasan K, Kurpad AV, Muthayya S, Hill JC, et al. Childhood cognitive ability: relationship to gestational diabetes mellitus in India. Diabetologia 2010; 53(10):2134-8.
  30. Cai S, Qiu A, Broekman BF, Wong EQ, Gluckman PD, Godfrey KM, et al. The influence of gestational diabetes on neurodevelopment of children in the first two years of life: a prospective study. PloS one 2016; 11(9):e0162113.
  31. Clausen TD, Mortensen EL, Schmidt L, Mathiesen ER, Hansen T, Jensen DM, et al. Cognitive function in adult offspring of women with gestational diabetes–the role of glucose and other factors. PLoS One 2013; 8(6):e67107.
  32. Yamashita Y, Kawano Y, Kuriya N, Murakami Y, Matsuishi T, Yoshimatsu K, et al. Intellectual development of offspring of diabetic mothers. Acta Paediatrica 1996; 85(10):1192-6.
  33. Rizzo T, Metzger BE, Burns WJ, Burns K. Correlations between antepartum maternal metabolism and intelligence of offspring. New England Journal of Medicine 1991; 325(13):911-6.
  34. He XJ, Dai RX, Tian CQ, Hu CL. Neurodevelopmental outcome at 1 year in offspring of women with gestational diabetes mellitus. Gynecological Endocrinology 2021; 37(1):88-92.
  35. Xu T, Faleschini S, Rifas‐Shiman SL, Monthé‐Drèze C, Oken E, Hivert MF, et al. Maternal glucose tolerance in pregnancy and child cognitive and behavioural problems in early and mid‐childhood. Paediatric and perinatal epidemiology 2021; 35(1):109-19.
  36. Heldarskard GF, Spangmose AL, Henningsen AK, Wiingreen R, Mortensen EL, Gundersen TW, et al. Academic performance in adolescents born to mothers with gestational diabetes—a national Danish cohort study. The Journal of Clinical Endocrinology & Metabolism 2021; 106(11):e4554-64.
  37. Thapar A, Cooper M. Attention deficit hyperactivity disorder. Lancet 2016; 387(10024):1240-50.
  38. Lord C, Elsabbagh M, Baird G, Veenstra-Vanderweele J. Autism spectrum disorder. The lancet 2018; 392(10146):508-20.
  39. Maulik PK, Mascarenhas MN, Mathers CD, Dua T, Saxena S. Prevalence of intellectual disability: a meta-analysis of population-based studies. Research in developmental disabilities 2011; 32(2):419-36.
  40. Grant R, Nozyce M. Proposed changes to the American Psychiatric Association diagnostic criteria for autism spectrum disorder: Implications for young children and their families. Maternal and child health journal 2013; 17(4):586-92.
  41. Lahey BB, Lee SS, Sibley MH, Applegate B, Molina BS, Pelham WE. Predictors of adolescent outcomes among 4–6-year-old children with attention-deficit/hyperactivity disorder. Journal of abnormal psychology 2016; 125(2):168.
  42. Jeste SS. Neurodevelopmental behavioral and cognitive disorders. CONTINUUM: Lifelong Learning in Neurology 2015; 21(3):690-714.
  43. Lende M, Rijhsinghani A. Gestational diabetes: overview with emphasis on medical management. International Journal of Environmental Research and Public Health 2020; 17(24):9573.
  44. O'sullivan JB, Mahan CM. Criteria for the Oral Glucose Tolerance Test in Pregnancy. Diabetes 1964; 13:278-85.
  45. Mishra S, Rao CR, Shetty A. Trends in the diagnosis of gestational diabetes mellitus. Scientifica 2016; 2016.
  46. Negrato CA, Gomes MB. Historical facts of screening and diagnosing diabetes in pregnancy. Diabetology & Metabolic Syndrome 2013; 5(1):1-8.
  47. International Association of Diabetes and Pregnancy Study Groups Consensus Panel. International association of diabetes and pregnancy study groups recommendations on the diagnosis and classification of hyperglycemia in pregnancy. Diabetes care 2010; 33(3):676-82.
  48. John CM, Mohamed Yusof NI, Abdul Aziz SH, Mohd Fauzi F. Maternal cognitive impairment associated with gestational diabetes mellitus—A review of potential contributing mechanisms. International journal of molecular sciences 2018; 19(12):3894.
  49. Kelstrup L, Bytoft B, Hjort L, Houshmand-Oeregaard A, Mathiesen ER, Damm P, et al. Diabetes in pregnancy: long-term complications of offsprings. InGestational diabetes 2020; 28:201-22.
  50. Fleming TP, Watkins AJ, Velazquez MA, Mathers JC, Prentice AM, Stephenson J, et al. Origins of lifetime health around the time of conception: causes and consequences. The Lancet 2018; 391(10132):1842-52.
  51. Kong L, Chen X, Gissler M, Lavebratt C. Relationship of prenatal maternal obesity and diabetes to offspring neurodevelopmental and psychiatric disorders: a narrative review. International Journal of Obesity 2020; 44(10):1981-2000.
  52. Bolaños L, Matute E, Ramírez-Dueñas MD, Zarabozo D. Neuropsychological impairment in school-aged children born to mothers with gestational diabetes. Journal of child neurology 2015; 30(12):1616-24.
  53. Aviel-Shekler K, Hamshawi Y, Sirhan W, Getselter D, Srikanth KD, Malka A, et al. Gestational diabetes induces behavioral and brain gene transcription dysregulation in adult offspring. Translational psychiatry 2020; 10(1):1-11.
  54. De Sousa RA. Animal models of gestational diabetes: characteristics and consequences to the brain and behavior of the offspring. Metabolic Brain Disease 2021; 36(2):199-204.
  55. Fraser A, Lawlor DA. Long-term health outcomes in offspring born to women with diabetes in pregnancy. Current diabetes reports 2014; 14(5):1-8.
  56. e Silva RN, Yu Y, Liew Z, Vested A, Sørensen HT, Li J. Associations of Maternal Diabetes during Pregnancy with Psychiatric Disorders in Offspring during the First 4 Decades of Life in a Population-Based Danish Birth Cohort. JAMA Network Open 2021; 4(10):e2128005-.
  57. Zhao L, Li X, Liu G, Han B, Wang J, Jiang X. The association of maternal diabetes with attention deficit and hyperactivity disorder in offspring: a meta-analysis. Neuropsychiatric disease and treatment 2019; 15:675.
  58. Lynch KM, Alves JM, Chow T, Clark KA, Luo S, Toga AW, et al. Selective morphological and volumetric alterations in the hippocampus of children exposed in utero to gestational diabetes mellitus. Human brain mapping 2021; 42(8):2583-92.
  59. Todi S, Sagili H, Kamalanathan SK. Comparison of criteria of International Association of Diabetes and Pregnancy Study Groups (IADPSG) with National Institute for Health and Care Excellence (NICE) for diagnosis of gestational diabetes mellitus. Archives of Gynecology and Obstetrics 2020; 302(1):47-52.
  60. Harper LM, Mele L, Landon MB, Carpenter MW, Ramin SM, Reddy UM, et al. Carpenter-Coustan compared with National Diabetes Data Group criteria for diagnosing gestational diabetes. Obstetrics and gynecology 2016; 127(5):893-8.
  61. Chien YL, Chou MC, Chou WJ, Wu YY, Tsai WC, Chiu YN, et al. Prenatal and perinatal risk factors and the clinical implications on autism spectrum disorder. Autism 2019; 23(3):783-91.
  62. Kania M, Herbut K, Dybała A, Linowska P, Małecki M, Kozek E. The association of maternal gestational diabetes mellitus with autism spectrum disorders in the offspring. Clinical Diabetology 2016; 5(5):147-51.
  63. Xiang AH, Wang X, Martinez MP, Walthall JC, Curry ES, Page K, et al. Association of maternal diabetes with autism in offspring. Jama 2015; 313(14):1425-34.
The Iranian Journal of Obstetrics, Gynecology and Infertility
Volume 25, Issue 9
November 2022
Pages 126-138