Children of mothers with obesity, gestational diabetes at higher risk for developing ADHD
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Children of women with gestational diabetes and pregestational obesity are more likely to develop ADHD than offspring of women with normal weight, according to study findings.
“Our study found pregnant women with obesity and gestational diabetes had children with long-term mental health disorders, such as ADHD,” Verónica Perea, MD, PhD, endocrinologist at Hospital Universitari Mutua Terrassa in Barcelona, Spain, said in a press release. “We did not find this association when these women gained a healthy amount of weight during pregnancy.”
Researchers conducted a cohort study of 1,036 children born from mothers with gestational diabetes from 1991 to 2008 at Hospital Universitari Mutua Terrassa. Pregestational BMI was calculated based on self-reported maternal weight before pregnancy. Overweight included women with a BMI of 25 kg/m2 to 29.9 kg/m2, and obesity was defined as a BMI of 30 kg/m2 or higher. Gestational weight gain was calculated as the difference between the final weight measured at the last antenatal visit and pregestational weight. The rate of gestational weight gain was defined as insufficient, adequate or excessive based on recommendations from the National Academy of Medicine. Children with ADHD were identified from medical records.
The findings were published in The Journal of Clinical Endocrinology & Metabolism.
Of mothers included in the study, 1.4% had underweight, 52.7% had normal weight, 27.1% had overweight and 18.8% had obesity. Excessive weight gain during pregnancy was observed in 28.8% of women with overweight and 30% of women with obesity. Women with obesity and excessive weight gain had higher rates of preeclampsia (18.6% vs. 0.8%; P < .001), cesarean section (40% vs. 17.4%; P = .001), labor induction (39.6% vs. 18.1%; P = .01), macrosomia (15.3% vs. 3.1%; P = .004) and large for gestational age (27.1% vs. 9.7%; P = .004) compared with women with normal weight and no excessive weight gain.
Children were followed for a median of 17.7 years, with 13% of offspring in the cohort having an incident case of ADHD. After adjusting for risk factors and gestational diabetes-related variables, children of women with obesity had an increased risk for ADHD compared with those with normal weight (adjusted HR = 1.66; 95% CI, 1.07-2.6).
Median maternal gestational weight gain was 9.5 kg in the cohort. Excessive gestational weight gain was not associated with an increased risk for ADHD. The offspring of women with obesity and excessive weight gain had an increased risk for ADHD compared with offspring of women with normal weight and no excessive weight gain (aHR = 2.13; 95% CI, 1.14-4.01), but no association was found between women with obesity and no excessive weight gain and women with normal weight and no excessive weight gain.
“The loss of association between maternal obesity and ADHD in offspring when National Academy of Medicine targets were not exceeded highlights that promoting healthy gain during pregnancy should be a priority in the current management of gestation,” the researchers wrote. “Nonetheless, future studies with larger sample sizes in broader populations are needed to confirm these results.”
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