Exploring the association between gestational diabetes exposure and mental and behavioural disorders in offspring: the Finnish gestational diabetes (FinnGeDi) register-based study

Abstract

Background: Gestational diabetes mellitus (GDM) is associated with an increased risk of attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) in offspring. Our aim was to investigate whether GDM exposure is linked to wider spectrum of mental and behavioural disorders in offspring during the first 10 years of life. Methods: This study included a population-based cohort of all women who delivered a singleton child in Finland in 2009, including 6,560 children exposed to maternal GDM and 51,770 control children. The main outcomes were the prevalence of mental and behavioural (including neurodevelopmental) disorders, and their subcategories, in study groups. Mother- and child-related covariates were adjusted for in the analyses. Results: Children exposed to GDM had a higher prevalence of mental and behavioural disorders (n = 1,010, 15.4%) compared with controls (n = 6,066, 11.7%; adjusted odds ratio (aOR): 1.18, 95% confidence interval [CI]: 1.09–1.28). In adjusted analyses, higher odds were observed only in boys (aOR: 1.25, 95% CI: 1.13–1.38). Specifically, GDM-exposed children had higher odds of behavioural disorders (aOR: 1.13, 95% CI: 1.02–1.25), developmental disorders (aOR: 1.14, 95% CI: 1.03–1.27) and behavioural disorders with physiological disturbances (aOR: 1.59, 95% CI: 1.16–2.18). Conclusions: Children exposed to maternal GDM have a higher prevalence of mental and behavioural disorders compared with non-exposed children. Notably, GDM exposure was shown to be an independent risk factor for these disorders in boys only.