Researchers from Edith Cowan University have found that intrauterine exposure to diabetes could be a crucial factor in a baby’s development.
The international study investigated links between maternal diabetes and infants’ development, with some surprising results.
A large effect was found for the association between pre-existing diabetes and psychomotor development index (PDI) scores. Infants born to mothers living with diabetes at age 12 months had significantly lower PDI scores than those born to mothers without diabetes.
Lower mental and psychomotor development scores were also reported for children born to mothers with gestational diabetes, and effect sizes were also higher in studies of infants aged 12 months in comparison to studies of infants aged 6 months and 18 months and older.
Lead author, Associate Professor Diana Arabiat from the University of Jordan, noted that intrauterine exposure to diabetes could impact child development through an increase in insulin resistance. This in turn could lead to higher glucose levels in the blood and an abnormal increase in ketone bodies that could lead to lower oxygen supply to the brain and altered chemical reactions in the brain cells.
“Children born to mothers with pre-existing diabetes may also have an altered fuel environment that could lead to issues with their growth and development, as high levels of glucose concentrate within the mother could impact the development of brain cells, pancreatic beta cells, fat, and muscle cells. This could result in neurodevelopmental consequences for the unborn child,” she said.
“This finding is consistent with recent reviews and a pairwise conventional meta-analysis that suggested intrauterine exposure to diabetes was associated with decreased scores for both fine and gross motor abilities and lower expressive language development compared to controls.
“The results of those reviews also raise the question of whether types of diabetes and other comorbidities, such as overweight and obesity, should be considered as additional moderating variables with potentially different clinical and physiological effects.”
However, Associate Professor Arabiat said the scores were only higher for children under 12 months.
“This suggests that using terms, such as ‘developmentally delayed’ or ‘impaired development’, for describing the development of infants of diabetic mothers may be an inappropriate characterisation since the results of the subgroup meta-analysis suggest these infants will exhibit ‘developmental spurts’ and catch up with their peers at age 18 months and older,” she said.
In addition, only one study reported a standardized mean score lower than 85 for children born to mothers with diabetes, the cut-off score for diagnosing developmental delay.
Associate Professor Arabiat said future research needed to consider the impact of maternal diabetes on child development within a larger context of interdependent elements and processes such as maternal comorbidity, parent and child relations, and socio-economic status.
“Studies that differentiate between type of diabetes and level of glycaemic control need to be conducted,” she said.
“Children born to mothers with pre-existing diabetes may experience greater developmental challenges than children born to mothers with gestational diabetes. Analysis that combines diabetes by type may fail to identify differences that exist within samples.”