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Offspring Born to Controlled Diabetes Mothers Performed Better At School

Study found a negative correlation between maternal A1c in pregnancy and primary school grades…

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Children born to mother with diabetes are known to be associated with adverse outcomes including premature birth, macrosomia and type 2 diabetes later in life. According to Dr. Sine Knorr at Aarhus University Hospital, uncontrolled mother’s blood sugar may also influence the child’s cognitive development.

In a study examining the effects of maternal pregestational type 1 diabetes on the cognitive development of the offspring, the researchers compared the primary school performance of 707 offspring born to mothers with pregestational type 1 diabetes. The results showed no difference in offspring born to mothers with pregestational type 1 diabetes when compared to control offspring (regression coefficient [β] = –0.13; 95% CI = –0.30 to 0.03; P = 0.12). However, among the offspring of type 1 diabetes mothers with their A1c increased throughout the pregnancy was linked to lower average school grades. Offspring born to mothers with good glycemic control tend to perform better at school and vice versa when compared to control offspring.

The study clearly demonstrated a relationship between mother’s A1c during pregnancy and the child performance at school. However, it is uncertain if high blood glucose levels during pregnancy affect the child’s cognitive development directly or other exposures that influence the mother’s ability to control the blood glucose level also affect the baby’s development.

According to Dr. Florence Brown, director of the Joslin Diabetes Center-Beth Israel Deaconess Diabetes and Pregnancy Program in Boston, "A mother’s social, psychological and cognitive function beyond her educational attainment would be expected both to improve her diabetes control and enrich the learning environment of her child." The results of the study still depicted a similar relationship between blood glucose control in pregnancy and the child’s grades after the researchers took into account that parental education can positively influence their child’s grade.

Overall, these results are only applied to type 1 diabetes mothers, further study is suggested in type 2 diabetes mothers. Nevertheless, good glycemic control during pregnancy is always recommended to prevent other complications that both the mother and the baby may encounter later in life.

Practice Pearls:

  • Uncontrolled mother’s blood sugar may also influence the child’s cognitive development.
  • Offspring of type 1 diabetes mothers with their A1c increased throughout the pregnancy was linked to lower average school grades. Offspring born to mothers with good glycemic control tend to better at school and have higher grades.
  • Good diabetes control prior to and during pregnancy helps lower risks for future complications.

Knorr S, Clausen TD, Vlachová Z, Bytoft B, Damm P, Beck-Nielsen H, Jensen DM, Juul S, Gravholt CH. Academic Achievement in Primary School in Offspring Born to Mothers With Type 1 Diabetes (the EPICOM Study): A Register-Based ProspectiveCohort Study. Diabetes Care. 2015 Jul; 38(7):1238-44. doi: 10.2337/dc15-0223.