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Cognitive function in adult offspring of women with gestational diabetes--the role of glucose and other factors.

Abstract

OBJECTIVE

We aimed to evaluate cognitive function in adult offspring of women with diet-treated gestational diabetes and to study potential associations with maternal glucose values.

MATERIALS AND METHODS

In 2003-2005 cognitive function was assessed in a cohort of 18-27 year old offspring of women with diet-treated gestational diabetes mellitus (n = 153) and offspring from the background population (n = 118). The main outcome measure was global cognitive score derived from Raven's Progressive Matrices and three verbal subtests from the Weschler Adult Intelligence Scale. Maternal fasting- and 2-hour blood glucose values from the diagnostic oral glucose tolerance test were used as exposure variables.

RESULTS

Offspring of women with gestational diabetes mellitus had a lower global cognitive score, than offspring from the background population (93.1 vs. 100.0, P<0.001). However, when adjusted for maternal age at delivery, parity, smoking during pregnancy, pre-pregnancy overweight, family social class, parental educational level, gender, birth weight, gestational age, perinatal complications and offspring age at follow-up, the difference was no longer statistically significant. Offspring global cognitive score decreased significantly with increasing maternal fasting glucose (β = -4.5, 95% CI -8.0 to -0.9, P = 0.01) and 2-hour glucose (β = -1.5, -2.9 to -0.2, P = 0.03) in univariate general linear models, but not when adjusted for family social class and parental educational level.

CONCLUSIONS

Lower cognitive test scores in adult offspring of women with diet-treated gestational diabetes were explained by well known predictors of cognitive function, but not by maternal hyperglycaemia during pregnancy. We find it reassuring that mild intrauterine hyperglycaemia does not seem to have adverse effect on offspring cognitive function.

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  • Authors+Show Affiliations

    ,

    Department of Gynecology and Obstetrics, Hilleroed Hospital, University of Copenhagen, Copenhagen, Denmark. tine.dalsgaard.clausen@dadlnet.dk

    , , , , ,

    Source

    PloS one 8:6 2013 pg e67107

    MeSH

    Adolescent
    Adult
    Adult Children
    Blood Glucose
    Case-Control Studies
    Cognition
    Diabetes, Gestational
    Female
    Follow-Up Studies
    Humans
    Male
    Pregnancy
    Prenatal Exposure Delayed Effects
    Treatment Outcome
    Young Adult

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    23840595

    Citation

    Clausen, Tine D., et al. "Cognitive Function in Adult Offspring of Women With Gestational Diabetes--the Role of Glucose and Other Factors." PloS One, vol. 8, no. 6, 2013, pp. e67107.
    Clausen TD, Mortensen EL, Schmidt L, et al. Cognitive function in adult offspring of women with gestational diabetes--the role of glucose and other factors. PLoS ONE. 2013;8(6):e67107.
    Clausen, T. D., Mortensen, E. L., Schmidt, L., Mathiesen, E. R., Hansen, T., Jensen, D. M., & Damm, P. (2013). Cognitive function in adult offspring of women with gestational diabetes--the role of glucose and other factors. PloS One, 8(6), pp. e67107. doi:10.1371/journal.pone.0067107.
    Clausen TD, et al. Cognitive Function in Adult Offspring of Women With Gestational Diabetes--the Role of Glucose and Other Factors. PLoS ONE. 2013;8(6):e67107. PubMed PMID: 23840595.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Cognitive function in adult offspring of women with gestational diabetes--the role of glucose and other factors. AU - Clausen,Tine D, AU - Mortensen,Erik L, AU - Schmidt,Lone, AU - Mathiesen,Elisabeth R, AU - Hansen,Torben, AU - Jensen,Dorte M, AU - Damm,Peter, Y1 - 2013/06/28/ PY - 2013/02/07/received PY - 2013/05/15/accepted PY - 2013/7/11/entrez PY - 2013/7/11/pubmed PY - 2014/1/22/medline SP - e67107 EP - e67107 JF - PloS one JO - PLoS ONE VL - 8 IS - 6 N2 - OBJECTIVE: We aimed to evaluate cognitive function in adult offspring of women with diet-treated gestational diabetes and to study potential associations with maternal glucose values. MATERIALS AND METHODS: In 2003-2005 cognitive function was assessed in a cohort of 18-27 year old offspring of women with diet-treated gestational diabetes mellitus (n = 153) and offspring from the background population (n = 118). The main outcome measure was global cognitive score derived from Raven's Progressive Matrices and three verbal subtests from the Weschler Adult Intelligence Scale. Maternal fasting- and 2-hour blood glucose values from the diagnostic oral glucose tolerance test were used as exposure variables. RESULTS: Offspring of women with gestational diabetes mellitus had a lower global cognitive score, than offspring from the background population (93.1 vs. 100.0, P<0.001). However, when adjusted for maternal age at delivery, parity, smoking during pregnancy, pre-pregnancy overweight, family social class, parental educational level, gender, birth weight, gestational age, perinatal complications and offspring age at follow-up, the difference was no longer statistically significant. Offspring global cognitive score decreased significantly with increasing maternal fasting glucose (β = -4.5, 95% CI -8.0 to -0.9, P = 0.01) and 2-hour glucose (β = -1.5, -2.9 to -0.2, P = 0.03) in univariate general linear models, but not when adjusted for family social class and parental educational level. CONCLUSIONS: Lower cognitive test scores in adult offspring of women with diet-treated gestational diabetes were explained by well known predictors of cognitive function, but not by maternal hyperglycaemia during pregnancy. We find it reassuring that mild intrauterine hyperglycaemia does not seem to have adverse effect on offspring cognitive function. SN - 1932-6203 UR - https://www.unboundmedicine.com/medline/citation/23840595/Cognitive_function_in_adult_offspring_of_women_with_gestational_diabetes__the_role_of_glucose_and_other_factors_ L2 - http://dx.plos.org/10.1371/journal.pone.0067107 DB - PRIME DP - Unbound Medicine ER -