Maternal gestational diabetes mellitus and mental disorders, neurodevelopmental disorders, and neurodevelopmental scale outcomes in offspring: a systematic review and meta-analysis

Abstract

The association between maternal gestational diabetes mellitus (GDM) and neuropsychiatric outcomes in offspring has not been fully systematically synthesized. We aimed to evaluate the association between maternal GDM and neuropsychiatric outcomes in offspring, including mental disorders, neurodevelopmental disorders, and abnormal neurodevelopmental scale scores. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used. Four electronic databases were searched. Observational studies examining the relationship between GDM and neuropsychiatric outcomes in offspring were included. The modified Newcastle-Ottawa scale (NOS) was used to assess the quality of the included studies. Subgroup analyses of study characteristics and confounders were conducted. Thirty-three studies involving approximately 18 million pregnant women or children were included. Offspring of mothers with GDM had 18% higher odds of adverse neuropsychiatric outcomes (odds ratio 1.18, 95% confidence interval 1.14 to 1.22), mental disorders by 8% (OR 1.08, 95% CI 1.03 to 1.14), neurodevelopmental disorders by 15% (OR 1.15, 95% CI 1.09 to 1.20), and abnormal neurodevelopmental scales by 26% (OR 1.26, 95% CI 1.16 to 1.38). The risk of abnormal ages and stages questionnaires (ASQ) increased by 27% (OR 1.27, 95% CI 1.16 to 1.39). Subgroup analysis showed that study location, study design, quality of study, maternal age, race, smoking, body mass index, educational level, parity, comorbidities, pregnancy complications, psychological disorder history, delivery mode, gestational weeks, birth weight and child’s sex significantly contributed to heterogeneity between studies for several neuropsychiatric outcomes in offspring. Maternal GDM is associated with an increased risk of adverse neuropsychiatric outcomes in offspring. This association retained statistical significance after adjusting for confounders.