Association between maternal diabetes and neurodevelopmental outcomes in children: a systematic review and meta-analysis of 202 observational studies comprising 56·1 million pregnancies
In studies adjusting for multiple confounders (n=98, 49%), children exposed to maternal diabetes had an increased risk of any neurodevelopmental disorder (risk ratio 1·28; 95% CI 1·24–1·31), autism spectrum disorder (1·25; 1·20–1·31), attention-deficit hyperactivity disorder (1·30; 1·24–1·37), intellectual disability (1·32; 1·18–1·47), specific developmental disorders (1·27; 1·17–1·37), communication disorder (1·20; 1·11–1·28), motor disorder (1·17; 1·10–1·26), and learning disorder (1·16; 1·06–1·26), compared with unexposed children. Maternal pre-gestational diabetes was more strongly associated with the risk of most neurodevelopmental disorders in children than gestational diabetes (risk ratio 1·39; [95% CI 1·34–1·44] vs 1·18 [1·14–1·23]; subgroup difference p<0·0001).
Diabetes has been dramatically increasing in the United States in recent years, and indeed, this has been the trend globally.
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