1195-P: Is Gestational Diabetes by IADPSG Criteria Associated with Risk of Autism in Offspring?

Abstract

We assessed whether only one abnormal value from the OGTT screening during pregnancy, which qualify as GDM by the IADPSG criteria (GDM_IADPSG), was associated with risk of offspring autism spectrum disorders (ASD). The cohort included 590,001 singletons from a large integrated healthcare system with electronic medical records. GDM was largely screened by two-steps and Carpenter-Coustan criteria (GDM_CC). We excluded those exposed to pre-existing diabetes or 1-hr 50g glucose challenge test ≥ 200mg/dl. OGTT glucose levels were used to define GDM_IADPSG. Cox models with hazard ratio (HR) were used to assess associations. Among the cohort, 7.6% were exposed to maternal GDM_CC, an additional 5.9% to GDM_IADPSG with only one abnormal OGTT value. Within GDM_CC, 41.3% had abnormal fasting, 30.5% were diagnosed at ≤ 26 wks and 30.7% prescribed medications. Within GDM_IADPSG, 28.4% had abnormal fasting alone, 27.0% at ≤ 26 wks and none received medications. Table 1 shows the HRs (95% CI). GDM_IADPSG was associated with increased risk of ASD, with risk slightly lower compared to GDM_CC. However, the risk appeared greater if abnormal fasting presented at diagnosis. The risk of ASD associated with GDM_IADPSG by abnormal fasting alone was comparable to GDM_CC treated with medications. Studies are needed to assess whether diabetes management for pregnancies with only elevated fasting will reduce adverse effect on offspring. Disclosure A.Xiang: None. S.A.Carter: None. J.C.Lin: None. T.Chow: None. M.P.Martinez: None. K.A.Page: None. R.Feldman: None.