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

Published online by Cambridge University Press:  04 April 2022

Angela Titmuss*
Affiliation:
Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia Paediatric Department, Division of Women, Children and Youth, Royal Darwin Hospital, Darwin, NT, Australia
Anita D’Aprano
Affiliation:
Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia Murdoch Children’s Research Institute, Melbourne, VIC, Australia Centre for Child Development and Education, Menzies School for Health Research, Charles Darwin University, Darwin, NT, Australia
Federica Barzi
Affiliation:
Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia Poche Centre for Indigenous Health, University of Queensland, Brisbane, QLD, Australia
Alex D.H. Brown
Affiliation:
Wardliparingga Aboriginal Research Unit, South Australian Health and Medical Research Institute, Adelaide, SA, Australia University of South Australia, Adelaide, SA, Australia
Anna Wood
Affiliation:
Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia Endocrinology Department, Division of Medicine, Royal Darwin Hospital, Darwin, NT, Australia
Christine Connors
Affiliation:
Northern Territory Department of Health, Darwin, NT, Australia
Jacqueline A. Boyle
Affiliation:
Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
Elizabeth Moore
Affiliation:
Public Health Unit, Aboriginal Medical Services Alliance of Northern Territory, Darwin, NT, Australia
Kerin OʼDea
Affiliation:
University of South Australia, Adelaide, SA, Australia
Jeremy Oats
Affiliation:
Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
H. David McIntyre
Affiliation:
Faculty of Medicine, Mater Medical Research Institute, University of Queensland, Brisbane, QLD, Australia
Paul Zimmet
Affiliation:
Department of Diabetes, Central Clinical School, Monash University, Melbourne, VIC, Australia
Jonathan E. Shaw
Affiliation:
Clinical and Population Health, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
Maria E. Craig
Affiliation:
School of Women and Children’s Health, University of New South Wales, Sydney, NSW, Australia
Louise J. Maple-Brown
Affiliation:
Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia Endocrinology Department, Division of Medicine, Royal Darwin Hospital, Darwin, NT, Australia
*
Address for correspondence: Dr Angela Titmuss, Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Charles Darwin University, PO Box 41096, Casuarina, NT, 0811, Australia. Email: Angela.titmuss@menzies.edu.au

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.

Type
Original Article
Copyright
© The Author(s), 2022. Published by Cambridge University Press in association with International Society for Developmental Origins of Health and Disease

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Footnotes

On behalf of the PANDORA Study research team.

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