Gestational diabetes mellitus and risk of neurodevelopmental disorders in young offspring: does the risk differ by race and ethnicity?

Abstract

BackgroundPrevious studies examined the associations of gestational diabetes mellitus (GDM) with autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD). However, the associations between GDM and other neurodevelopmental disorders (NDDs), such as the common speech/language disorder (SLD) and developmental coordination disorder (DCD), are rarely studied and whether the associations vary by race/ethnicity remains unknown. ObjectiveTo examine the associations of GDM with individual NDDs in young offspring and investigate whether the associations varied by race/ethnicity. Study DesignThis retrospective cohort study (Glucose in Relation to Women and Babies’ Health [GrownB]) included 14,480 mother-offspring pairs in a large medical center in the United States (US) from 3/1/2013 to 8/31/2021. We ascertained GDM using the validated International Classification of Disease (ICD) codes (ICD-9: 648.8x; ICD-10: O24.4x), and identified NDDs (SLD, DCD, ASD, and other NDDs [ADHD, behavioral disorder, intellectual disability, and learning difficulty]) and their combinations using validated algorithms. We compared the hazard of NDDs during the entire follow-up period between offspring born to mothers with and without GDM using multivariable Cox regression models. ResultsAmong all mothers, 19.9% were Asians, 21.8% were Hispanics, 41.0% were non-Hispanic Whites, and 17.3% were other/unknown race/ethnicity. During the median follow-up of 3.5 years (range: 1.0-6.3 years) after birth, 8.7% of offspring developed at least one NDD. GDM was associated with a higher risk of SLD (adjusted hazard ratio: 1.59 [95% confidence interval, 1.07, 2.35]), DCD (2.36 [1.37, 4.04]), ASD (3.16 [1.36, 7.37]), other NDDs (3.12 [1.51, 6.47]), any NDD (1.86 [1.36, 2.53]), combination of SLD and ASD (3.79 [1.35, 10.61]), and combination of SLD and DCD (4.22 [1.69, 10.51]) among offspring born to non-Hispanic White mothers. No associations between GDM and any NDDs or their combinations were observed among offspring born to mothers of other racial/ethnic groups. ConclusionsWe observed an elevated risk of NDDs in young offspring born to non-Hispanic White mothers with GDM, but not among other racial/ethnic groups.