Gestational Diabetes May Impact Child's Autism Risk
In a study published in JAMA, intrauterine exposure to gestational diabetes by 26 weeks was linked to a risk of autism spectrum disorders (ASDs).
Earlier research has shown long-term risks of obesity and other metabolic disorders related to offspring of women who had diabetes pre-pregnancy as well as women with gestational diabetes mellitus (GDM). However, it was unclear whether exposure could impact fetal brain development and increase risk of neurobehavioral disorders in offspring. Dr. Anny H. Xiang, of Kaiser Permanente Southern California, and colleagues looked at data from a single healthcare system to study the relationship between diagnosed maternal diabetes (both before and during pregnancy) and the risk of ASD in children. A total of 322,323 children born between 1995-2009 were included and were followed from birth until the first of the following: date of clinical ASD diagnosis, last date of continuous KPSC health plan membership, death due to any cause, or December 31, 2012.
Of the 3,388 children diagnosed with ASD, 115 were exposed to pre-existing type 2 diabetes, 130 were exposed to GDM at 26 weeks or earlier, 180 were exposed to GDM at more than 26 weeks, and 2,963 were unexposed. After adjusting for factors such as maternal age, household income, race/ethnicity, sex of the child, researchers concluded that GDM diagnosed by 26 weeks was significantly associated with risk of ASD in offspring, but maternal pre-existing type 2 diabetes was not. The team also found that the use of antidiabetics was not independently linked to ASD risk in offspring.
Possible mechanisms that may explain the link between intrauterine hyperglycemia and ASD risk in offspring may include: fetal hypoxia, oxidative stress in cord blood and placental tissue, chronic inflammation, and epigenetics, researchers concluded.
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