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Maternal Diabetes and Cognitive Performance in the Offspring: A Systematic Review and Meta-Analysis.

Camprubi Robles M, Campoy C, Garcia Fernandez L, Lopez-Pedrosa JM, Rueda R, Martin MJ - PLoS ONE (2015)

Bottom Line: Infants (1-2 years) of diabetic mothers had significantly lower scores of mental and psychomotor development compared to control infants.The effect size for mental development was -0.41 (95% CI -0.59, -0.24; p<0.0001) and for psychomotor development was -0.31 (95% CI -0.55, -0.07; p = 0.0125) with non-significant heterogeneity.Diabetes during pregnancy could be associated with decreased intelligence quotient scores in school-age children, although studies showed significant heterogeneity.

View Article: PubMed Central - PubMed

Affiliation: Abbott Nutrition, Research and Development-University Science Park, Granada, Spain.

ABSTRACT

Objective: Diabetes during gestation is one of the most common pregnancy complications associated with adverse health effects for the mother and the child. Maternal diabetes has been proposed to negatively affect the cognitive abilities of the child, but experimental research assessing its impact is conflicting. The main aim of our study was to compare the cognitive function in children of diabetic and healthy pregnant women.

Methods: A systematic review and meta-analysis was conducted through a literature search using different electronic databases from the index date to January 31, 2015. We included studies that assessed the cognitive abilities in children (up to 14 years) of diabetic and non-diabetic mothers using standardized and validated neuropsychological tests.

Results: Of 7,698 references reviewed, 12 studies involving 6,140 infants met our inclusion criteria and contributed to meta-analysis. A random effect model was used to compute the standardized mean differences and 95% confidence interval (CI) were calculated. Infants (1-2 years) of diabetic mothers had significantly lower scores of mental and psychomotor development compared to control infants. The effect size for mental development was -0.41 (95% CI -0.59, -0.24; p<0.0001) and for psychomotor development was -0.31 (95% CI -0.55, -0.07; p = 0.0125) with non-significant heterogeneity. Diabetes during pregnancy could be associated with decreased intelligence quotient scores in school-age children, although studies showed significant heterogeneity.

Conclusion: The association between maternal diabetes and deleterious effects on mental/psychomotor development and overall intellectual function in the offspring must be taken with caution. Results are based on observational cohorts and a direct causal influence of intrauterine hyperglycemia remains uncertain. Therefore, more trials that include larger populations are warranted to elucidate whether gestational diabetes mellitus (GDM) has a negative impact on offspring central nervous system (CNS).

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Related in: MedlinePlus

Effect of pregnancy diabetes on the mental and psychomotor development and intelligence quotient.Forest plots comparing the difference in the (A) Mental Development Index and (B) Psychomotor Development Index subscales of the BSID between children of diabetic and non-diabetic mothers. (C) Forest plots comparing the difference in the intelligence quotient yielded by combined data from the Wechsler scales and the Stanford-Binet intelligence scale between children of diabetic and non-diabetic mothers.
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pone.0142583.g002: Effect of pregnancy diabetes on the mental and psychomotor development and intelligence quotient.Forest plots comparing the difference in the (A) Mental Development Index and (B) Psychomotor Development Index subscales of the BSID between children of diabetic and non-diabetic mothers. (C) Forest plots comparing the difference in the intelligence quotient yielded by combined data from the Wechsler scales and the Stanford-Binet intelligence scale between children of diabetic and non-diabetic mothers.

Mentions: Data from the 7 studies were combined using random effect models and the results are shown in Fig 2A. The combined SMD and the 95% CIs are presented using both a univariate and a multivariate random effect model adjusted by the age of infants. Although for the univariate model the χ2 test for heterogeneity showed a non-significant result, the I2 index showed low to moderate non-significant variation (19.5%). Variation disappeared (I2 = 0) after adjusting by age, showing a significant effect of this variable (p = 0.043). The combined effect was 0.41 lower for those infants of diabetic mothers, being the results significant at 5% level and with 95% CI (-0.59, -0.24).


Maternal Diabetes and Cognitive Performance in the Offspring: A Systematic Review and Meta-Analysis.

Camprubi Robles M, Campoy C, Garcia Fernandez L, Lopez-Pedrosa JM, Rueda R, Martin MJ - PLoS ONE (2015)

Effect of pregnancy diabetes on the mental and psychomotor development and intelligence quotient.Forest plots comparing the difference in the (A) Mental Development Index and (B) Psychomotor Development Index subscales of the BSID between children of diabetic and non-diabetic mothers. (C) Forest plots comparing the difference in the intelligence quotient yielded by combined data from the Wechsler scales and the Stanford-Binet intelligence scale between children of diabetic and non-diabetic mothers.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4643884&req=5

pone.0142583.g002: Effect of pregnancy diabetes on the mental and psychomotor development and intelligence quotient.Forest plots comparing the difference in the (A) Mental Development Index and (B) Psychomotor Development Index subscales of the BSID between children of diabetic and non-diabetic mothers. (C) Forest plots comparing the difference in the intelligence quotient yielded by combined data from the Wechsler scales and the Stanford-Binet intelligence scale between children of diabetic and non-diabetic mothers.
Mentions: Data from the 7 studies were combined using random effect models and the results are shown in Fig 2A. The combined SMD and the 95% CIs are presented using both a univariate and a multivariate random effect model adjusted by the age of infants. Although for the univariate model the χ2 test for heterogeneity showed a non-significant result, the I2 index showed low to moderate non-significant variation (19.5%). Variation disappeared (I2 = 0) after adjusting by age, showing a significant effect of this variable (p = 0.043). The combined effect was 0.41 lower for those infants of diabetic mothers, being the results significant at 5% level and with 95% CI (-0.59, -0.24).

Bottom Line: Infants (1-2 years) of diabetic mothers had significantly lower scores of mental and psychomotor development compared to control infants.The effect size for mental development was -0.41 (95% CI -0.59, -0.24; p<0.0001) and for psychomotor development was -0.31 (95% CI -0.55, -0.07; p = 0.0125) with non-significant heterogeneity.Diabetes during pregnancy could be associated with decreased intelligence quotient scores in school-age children, although studies showed significant heterogeneity.

View Article: PubMed Central - PubMed

Affiliation: Abbott Nutrition, Research and Development-University Science Park, Granada, Spain.

ABSTRACT

Objective: Diabetes during gestation is one of the most common pregnancy complications associated with adverse health effects for the mother and the child. Maternal diabetes has been proposed to negatively affect the cognitive abilities of the child, but experimental research assessing its impact is conflicting. The main aim of our study was to compare the cognitive function in children of diabetic and healthy pregnant women.

Methods: A systematic review and meta-analysis was conducted through a literature search using different electronic databases from the index date to January 31, 2015. We included studies that assessed the cognitive abilities in children (up to 14 years) of diabetic and non-diabetic mothers using standardized and validated neuropsychological tests.

Results: Of 7,698 references reviewed, 12 studies involving 6,140 infants met our inclusion criteria and contributed to meta-analysis. A random effect model was used to compute the standardized mean differences and 95% confidence interval (CI) were calculated. Infants (1-2 years) of diabetic mothers had significantly lower scores of mental and psychomotor development compared to control infants. The effect size for mental development was -0.41 (95% CI -0.59, -0.24; p<0.0001) and for psychomotor development was -0.31 (95% CI -0.55, -0.07; p = 0.0125) with non-significant heterogeneity. Diabetes during pregnancy could be associated with decreased intelligence quotient scores in school-age children, although studies showed significant heterogeneity.

Conclusion: The association between maternal diabetes and deleterious effects on mental/psychomotor development and overall intellectual function in the offspring must be taken with caution. Results are based on observational cohorts and a direct causal influence of intrauterine hyperglycemia remains uncertain. Therefore, more trials that include larger populations are warranted to elucidate whether gestational diabetes mellitus (GDM) has a negative impact on offspring central nervous system (CNS).

Show MeSH
Related in: MedlinePlus