Gestational Diabetes and Maternal Obesity Have “Unfavorable” Effects on Neurodevelopment in Children

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Gestational diabetes mellitus (GDM) and higher maternal adiposity may lead to weaker neurodevelopmental skills in children aged 2 years, according to a new study conducted at the University of Turku in Finland.

Findings published in the journal Pediatric Research showed that higher fish consumption and good dietary quality during pregnancy were associated with more favorable neurodevelopment in children.

“Our findings reveal that women with overweight or obesity, a risk group for pregnancy complications, could benefit from dietary counseling to support their children’s neurodevelopment,” wrote first author Lotta Saros, doctoral student, Institute of Biomedicine, University of Turku, and colleagues.

Pregnant women with overweight or obesity are prone to develop metabolic disturbances, including GDM and birth complications, compared to women with normal weight. These metabolic disturbances during pregnancy may affect the long-term neurodevelopment of children via fetal programming, “by triggering changes in fetal brain development, thus disturbing optimal growth and development in the uterus,” according to investigators.

Saros and colleagues conducted a longitudinal study to investigate whether maternal GDM, obesity, and diet could affect the neurodevelopment of 243 children aged 2 years born to mothers with overweight or obesity. The research team examined the development of children’s cognitive, language, and motor skills.

Maternal adiposity was determined by air displacement plethysmography, and GDM was determined with an oral glucose tolerance test. Dietary intake during pregnancy was assessed with diet quality and fish consumption questionnaires, as well as 3-day food diaries, from which dietary inflammatory index (DII®) scores were computed, according to the study.

In adjusted models, GDM was associated with weaker expressive language skills (adjusted [adj] β −1.12, 95% CI −2.10 to −0.15), and higher maternal adiposity was associated with weaker cognitive, language, and motor skills (P<.05) in children.

“Our observation is unique, as previous studies have not examined the association between maternal body composition and children's neurodevelopment,” said Saros in a university press release.

Furthermore, investigators found that maternal good dietary quality (adj β 0.87, 95% CI .004; 1.73) and higher fish consumption (adj P=.02) were related to better expressive language skills. DII scores were not associated with the neurodevelopment in children.

“Our findings emphasize that maternal metabolic health and even subtle changes in dietary quality and composition during pregnancy may influence the child’s neurodevelopment,” concluded the research team.

Limitations to the study include the fact that women with normal weight were not included; data on breastfeeding was not available from all the mothers so the analysis was not adjusted for it; and the inflammatory status of the mothers was not investigated although diet-induced inflammation was.

Reference: Saros L, Laitinen K, Lind A, et al. Maternal obesity, gestational diabetes mellitus, and diet in association with neurodevelopment of 2-year-old children. Pediatric Res. Published online January 3, 2023. Doi:10.1038/s41390-022-02455-4.