Mums’ diabetes may up autism risk in kids
The risk of autism may be higher in children of mothers with type 1 diabetes (T1D) than those without, suggests a retrospective cohort analysis.
With T1D in pregnancy, the autism risk in children born to diabetic mothers was more than twofold (hazard ratio [HR, 2.33; p=0.005) that of the risk in children of mothers whose pregnancies were not complicated by diabetes. Of 419,425 children included in the analysis, 621 were exposed to maternal T1D, 9,453 to maternal T2D, 11,922 to gestational diabetes diagnosed by 26 weeks of gestation, and 24,505 to gestational diabetes diagnosed after 26 weeks of gestation. Overall, 5,827 children were diagnosed with autism. [ADA 2018, abstract 117-OR]
Electronic records of singleton children born between 28–44 weeks at Kaiser Permanente Southern California hospitals in the US were tracked for a median follow-up of 6.9 years for a clinical diagnosis of autism. T1D was identified and validated by insulin prescription during pregnancy.
“It surprises us that the risk of autism was quite high for children born to mothers with T1D,” said Dr Anny Xiang from Kaiser Permanente, Pasadena, California, US who presented the results at ADA 2018. “These results add new information on T1D and extend previous findings for pre-existing T2D and gestational diabetes.”
Session moderator Dr Peter Damm, professor in obstetrics at Rigshospitalet, Copenhagen, Denmark, said it was a strong study, but with a few limitations. Although diabetes in pregnancy appears to up the risk of autism in children, the risk is very small to start with, he added. “I would never raise this issue with a patient, unless she asked me.”
In the study, all mothers with T1D and T2D were on antidiabetic medications during pregnancy. Only 29 percent of those with gestational diabetes received the same therapy.
The risks associated with antidiabetic mediations were not significantly different between those with and without antidiabetic medication exposure in the gestational diabetes group (adjusted HR, 1.18; p=0.10).
As pregnancy is a screening opportunity for women with an existing underlying defect, Xiang said young mothers identified to have glucose intolerance may be at risk of developing gestational diabetes and possibly diabetes. “It is important for patient and clinician to monitor glucose control and ensure it is normal from the time of conception.”
“But I don’t think the results will change practice,” added Damm.