News & Research

Exposure to Gestational Diabetes Mellitus and Low Socioeconomic Status: Effects on Neurocognitive Development and Risk of Attention-Deficit/Hyperactivity Disorder in Offspring by Nomura and colleagues. Archives of Pediatrics & Adolescent Medicine 2 January 2012; doi:10.1001/archpediatrics.2011.784

What is the problem and what is known about it so far?

Gestational diabetes, a type that occurs in pregnant women that goes away after giving birth, is on the rise, particularly among women of low socioeconomic status. The condition, if not carefully controlled, can cause problems for the baby in the short-term, such as birth complications, but less is known about the long-term neurological effects. There is a strong association between low socioeconomic households and the development of attention-deficit/hyperactivity disorder (ADHD). ADHD is highly heritable, but there are environmental factors that contribute to its development as well. These environmental factors are not well understood, which prevent people from taking effective steps to prevent this disorder in children.

Why did the researchers do this particular study?

The researchers attempted to determine the relationship between ADHD, socioeconomic status, and gestational diabetes to help tease out the environmental factors that contribute to the neurological disorder.

Who was studied?

The researchers included 212 preschool children in Flushing, New York.

How was the study done?

Parents and teachers of preschoolers completed a test designed to determine the likelihood that the children have ADHD. The parents also gave information regarding their socioeconomic status and whether the mother developed gestational diabetes during pregnancy. When the children were around three to four years old, they were given psychological, emotional, and temperament evaluations. The researchers checked back in with the children at age 6, assessing behavior and emotional functioning with another test. Using this data, the researchers analyzed their data using standard statistical methods.

What did the researchers find?

Taken separately, neither a mother’s gestational diabetes nor low socioeconomic status impacted her offspring’s risk for ADHD. However, when an unborn child is exposed to both conditions, their risk for ADHD rises significantly--as does their risk for other types of psychological dysfunction.

What were the limitations of the study?

The gestational diabetes status of the mothers was self-reported, which doesn’t always provide accurate results. Furthermore, it may be the mothers’ blood glucose levels that affect the brain development of the fetus, not her gestational diabetes status itself, and the researchers did not have access to such data. Also, family history of ADHD wasn’t fully taken into account when calculating results, so genetic factors may have had a hand in the outcomes.

What are the implications of the study?

Now that it’s known that the children of low-income mothers with gestational diabetes are at greater risk for ADHD, efforts can be taken to help prevent the condition among such children. For example, targeted prevention of gestational diabetes in low-income communities, or more effective management of the condition, may help prevent ADHD in children. More research is needed to determine if gestational diabetes raises the risk for ADHD in particular, or if it triggers a wider range of psychological problems in children.

For More Information

ADA Guide to Raising a Child with Diabetes

Diabetes & Pregnancy: A Guide to a Healthy Pregnancy

Hyperactivity in Childhood May Raise the Risk of Obesity in Adulthood