Hyperglycemia in pregnancy and developmental outcomes in children at 18-60 months of age: the PANDORA Wave 1 study

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  (Published version)

Date

2022

Authors

Titmuss, A.
D'Aprano, A.
Barzi, F.
Brown, A.D.H.
Wood, A.
Connors, C.
Boyle, J.A.
Moore, E.
O'Dea, K.
Oats, J.

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Journal article

Citation

Journal of Developmental Origins of Health and Disease, 2022; 13(6):695-705

Statement of Responsibility

Angela Titmuss, Anita D, Aprano, Federica Barzi, Alex D.H. Brown, Anna Wood, Christine Connors, Jacqueline A. Boyle, Elizabeth Moore, Kerin O'Dea, Jeremy Oats, H. David McIntyre, Paul Zimmet, Jonathan E. Shaw, Maria E. Craig and Louise J. Maple-Brown

Conference Name

DOI

10.1017/S2040174422000101

Abstract

This study aimed to explore the association between hyperglycemia in pregnancy (type 2 diabetes (T2D) and gestational diabetes mellitus (GDM)) and child developmental risk in Europid and Aboriginal women.PANDORA is a longitudinal birth cohort recruited from a hyperglycemia in pregnancy register, and from normoglycemic women in antenatal clinics. The Wave 1 substudy included 308 children who completed developmental and behavioral screening between age 18 and 60 months. Developmental risk was assessed using the Ages and Stages Questionnaire (ASQ) or equivalent modified ASQ for use with Aboriginal children. Emotional and behavioral risk was assessed using the Strengths and Difficulties Questionnaire. Multivariable logistic regression was used to assess the association between developmental scores and explanatory variables, including maternal T2D in pregnancy or GDM.After adjustment for ethnicity, maternal and child variables, and socioeconomic measures, maternal hyperglycemia was associated with increased developmental "concern" (defined as score ≥1 SD below mean) in the fine motor (T2D odds ratio (OR) 5.30, 95% CI 1.77-15.80; GDM OR 3.96, 95% CI 1.55-10.11) and problem-solving (T2D OR 2.71, 95% CI 1.05-6.98; GDM OR 2.54, 95% CI 1.17-5.54) domains, as well as increased "risk" (score ≥2 SD below mean) in at least one domain (T2D OR 5.33, 95% CI 1.85-15.39; GDM OR 4.86, 95% CI 1.95-12.10). Higher maternal education was associated with reduced concern in the problem-solving domain (OR 0.27, 95% CI 0.11-0.69) after adjustment for maternal hyperglycemia.Maternal hyperglycemia is associated with increased developmental concern and may be a potential target for intervention so as to optimize developmental trajectories.

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Description

First published online: 4 April 2022

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© The Author(s), 2022. Published by Cambridge University Press in association with International Society for Developmental Origins of Health and Disease. This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https:// creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Grant ID

http://purl.org/au-research/grants/nhmrc/1078333
 http://purl.org/au-research/grants/nhmrc/GNT1114760
 http://purl.org/au-research/grants/nhmrc/1078477
 http://purl.org/au-research/grants/nhmrc/1194698
 http://purl.org/au-research/grants/nhmrc/1079438
 http://purl.org/au-research/grants/nhmrc/1137563
 http://purl.org/au-research/grants/nhmrc/1136735

Published Version

https://doi.org/10.1017/s2040174422000101

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Persistent link to this record

https://hdl.handle.net/2440/138435