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. Author manuscript; available in PMC: 2021 Feb 23.
Published in final edited form as: Ann Nutr Metab. 2021 Jan 19;76 Suppl 3(Suppl 3):4–15. doi: 10.1159/000509902

Table 3. Selected studies linking GDM with neurodevelopmental outcomes.

Study Design Cohort Sample size GDM criteria Offspring age (years) Major outcomes for GDM-exposed offspring
Kong et al. (2018) [36] Sweden Cohort Data linkage of Finland’s nationwide registers 649,043 Medical record From birth to 11

  • GDM + maternal obesity associated with autism spectrum disorders (HR: 1.56, 95% CI: 1.26–1.93)

  • Non-significant increase in GDM + normal weight for autism, adjusted for maternal psychiatric disorder, maternal age at delivery, maternal smoking and maternal systemic inflammatory disease
Nahum Sacks et al. (2016) [38] Israel Cohort A university medical center which serves the entire population of the Southern region of Israel 231,271 Medical record Not specified (study population included all patients who delivered between the years 1991 through 2014 and their offspring)

  • Associated with autistic spectrum disorder (OR: 4.44; 95% CI: 1.55–12.69), adjusted for maternal age, obesity, gestational week
Robles et al. (2015) [32] Spain Meta-analysis Included 7 cohort studies; USA, Israel 6,140 Exposure: maternal diabetes (regardless of type) 1–2 years for mental and psychomotor development; 3-12 years for Intelligence Quotient (IQ) Maternal diabetes associated with mental development (SMD: -0.41, 95% CI: -0.59 to -0.24), psychomotor development (-0.31, -0.55 to -0.07) and IQ (-0.78, -1.42 to -0.13)
Wan et al. (2018) [35] China Meta-analysis Included 16 case-control/cohort studies; USA, Canada, Sweden, Israel, Australia, Egypt Not specified Exposure: Maternal diabetes Not specified Associated with autism spectrum disorders (relative risk: 1.48; 95% CI: 1.26–1.75), adjusted for obesity, maternal age, gestational age
Xiang et al. (2018) [34] USA Cohort Kaiser Permanente Southern California hospitals (retrospective birth cohort) 29,534 Carpenter-Coustan Median age: 4.9

  • GDM requiring antidiabetic medications associated with ADHD (HR: 1.26, 95% CI: 1.14-1.41)

  • No association for GDM not requiring medications
Zhao et al. (2019) [33] China Meta-analysis Included 4 cohort studies; Denmark, Greece, USA, China 985,984 Medical record, self-report, ADA criteria Range: 4–19 Associated with ADHD (RR: 2.00, 95% CI 1.42–2.81)

ADHD, Attention deficit hyperactivity disorder; CI, confidence interval; GDM, gestational diabetes mellitus; HR, hazard ratio; OR, odds ratio; RR, risk ratio