Maternal Pregestational and Gestational Diabetes and Neuropsychiatric Risk in Offspring: A Binational Cohort Study

Résumé fourni par la source

AIMS: Maternal diabetes during pregnancy has been associated with long-term health outcomes in offspring, but studies on specific neuropsychiatric outcomes remain limited. We aimed to evaluate the association between maternal diabetes and neuropsychiatric disorders. MATERIALS AND METHODS: This binational cohort study included 2 722 687 mother-child pairs from South Korea and 181 134 mother-child pairs from Japan, from 2010 to 2017, followed until December 31, 2023. Maternal diabetes was categorized as pregestational or gestational using ICD-10 codes. Offspring outcomes included severe neuropsychiatric disorder, obsessive-compulsive disorder, attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD), and intellectual disability. Adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazards models in a stabilized inverse probability of treatment weighted cohort and sibling-comparison cohort. Sibling-comparison analyses were conducted and validated in an independent Japanese cohort. RESULTS: Among 2 722 687 mother-child pairs (mean follow-up, 10.3 years) in the full cohort, 783 265 offspring (26.7%) were exposed to maternal diabetes (756 193 gestational; 20 815 pregestational). Pregestational diabetes was associated with increased risks of any neuropsychiatric disorder (aHR, 1.29 [95% CI, 1.22-1.36]), severe neuropsychiatric disorder (1.33 [1.16-1.53]), ADHD (1.24 [1.16-1.31]), ASD (1.39 [1.25-1.55]), and intellectual disability (1.57 [1.40-1.77]). Associations remained consistent across maternal and perinatal subgroups. Gestational diabetes showed only modest associations (aHR, 1.05 [95% CI, 1.00-1.08]) and was nonsignificant in sibling analyses in both Korea (1.01 [0.98-1.05]) and Japan (0.90 [0.76-1.06]). CONCLUSIONS: Pregestational diabetes was associated with increased neuropsychiatric risk in offspring, whereas gestational diabetes showed no meaningful association in sibling analyses, and adequate management before and during pregnancy remains important.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.