Gestational diabetes can have long-term effects on women’s health. Credit: Yui Mok/PA Images via Alamy
Last week, a study involving more than nine million pregnancies reported that children whose mothers had gestational diabetes during pregnancy had a higher chance of developing attention deficit–hyperactivity disorder (ADHD) and autism than did children whose mothers didn’t have the condition.
The study, presented at the European Association for the Study of Diabetes in Vienna, is under review at a peer-reviewed journal. It is not the first to link gestational diabetes to neurodevelopmental disorders in children, but it is one of the largest. Researchers pooled results from 48 studies across 20 countries, finding that children born to people with gestational diabetes had lower IQ scores, a 36% higher risk of ADHD and a 56% higher risk of autism spectrum disorders. Estimates suggest the prevalence of autism in the general population is one in 127 people1 and between 3-10%2 of children and teenagers have ADHD.
The latest results mirror those of another meta-analysis3 published in The Lancet Diabetes & Endocrinology journal in June, which included 56 million mother–child pairs and found that all types of diabetes in pregnancy, including type 1, type 2 and gestational diabetes, increase the risk of the baby developing ADHD and autism. But none of these studies have been able to show that diabetes during pregnancy causes these conditions. “There’s no doubt that there is a signal here, but certainly further research is required,” says Alex Polyakov, an obstetrician and researcher at the University of Melbourne in Australia.
Long a topic of research, the causes of autism have been thrust into the spotlight by the administration of US President Donald Trump. On Sunday, while speaking at the memorial for conservative activist Charlie Kirk, Trump said: “I think we found an answer to autism. How about that?” The Washington Post reports that Trump’s administration is poised to announce a link between autism and the use of acetaminophen, also called paracetamol, during pregnancy. Medical guidelines say acetominophen is safe to use during pregnancy.
Overall, genetics has the strongest influence on the risk of developing ADHD and autism. Environmental factors, such as folic-acid deficiency, air pollution and gestational diabetes, have a small-to-moderate effect on the risk of these conditions, says Ling-Jun Li, a clinician–scientist at the National University of Singapore and a co-author on the latest gestational diabetes study.
Polyakov agrees: “In practice, both genetic predisposition and environmental factors likely interact.”
Health impacts
Studies over the past two decades5 have shown that gestational diabetes has long-term effects on women’s health, such as increasing their risk of type 2 diabetes, heart disease, stroke and chronic kidney disease.
Li and her colleagues decided to review the evidence for effects of the condition on neurocognitive development in children.