Abstract
ObjectiveWe aimed to evaluate cognitive function in adult offspring of women with diet-treated gestational diabetes and to study potential associations with maternal glucose values.Materials and MethodsIn 2003–2005 cognitive function was assessed in a cohort of 18–27 year old offspring of women with diet-treated gestational diabetes mellitus (n = 153) and offspring from the background population (n = 118). The main outcome measure was global cognitive score derived from Raven’s Progressive Matrices and three verbal subtests from the Weschler Adult Intelligence Scale. Maternal fasting- and 2-hour blood glucose values from the diagnostic oral glucose tolerance test were used as exposure variables.ResultsOffspring of women with gestational diabetes mellitus had a lower global cognitive score, than offspring from the background population (93.1 vs. 100.0, P<0.001). However, when adjusted for maternal age at delivery, parity, smoking during pregnancy, pre-pregnancy overweight, family social class, parental educational level, gender, birth weight, gestational age, perinatal complications and offspring age at follow-up, the difference was no longer statistically significant. Offspring global cognitive score decreased significantly with increasing maternal fasting glucose (β = −4.5, 95% CI −8.0 to −0.9, P = 0.01) and 2-hour glucose (β = −1.5, −2.9 to −0.2, P = 0.03) in univariate general linear models, but not when adjusted for family social class and parental educational level.ConclusionsLower cognitive test scores in adult offspring of women with diet-treated gestational diabetes were explained by well known predictors of cognitive function, but not by maternal hyperglycaemia during pregnancy. We find it reassuring that mild intrauterine hyperglycaemia does not seem to have adverse effect on offspring cognitive function.
Highlights
Hyperglycaemia during the fetal state has long-term effects on offspring metabolism leading to increased risk of overweight and cardiovascular disease
Offspring global cognitive score decreased significantly with increasing maternal fasting glucose (b = 24.5, 95% confidence interval (CI) 28.0 to 20.9, P = 0.01) and 2-hour glucose (b = 21.5, 22.9 to 20.2, P = 0.03) in univariate general linear models, but not when adjusted for family social class and parental educational level
Lower cognitive test scores in adult offspring of women with diet-treated gestational diabetes were explained by well known predictors of cognitive function, but not by maternal hyperglycaemia during pregnancy
Summary
Hyperglycaemia during the fetal state has long-term effects on offspring metabolism leading to increased risk of overweight and cardiovascular disease. This has been documented in animal intervention studies [1], [2] as well as follow-up studies in human populations of varying ethnic background [3,4,5,6,7], and the pathogenesis may involve epigenetic changes of gene expression [8]. There are no animal studies which investigate the potential adverse impact of intrauterine hyperglycaemia on offspring cognitive function
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