Hyperglycemia in pregnancy and developmental outcomes in children at 18-60 months of age: The PANDORA Wave 1 study

Angela Titmuss; Anita D'Aprano; Federica Barzi; Alex D.H. Brown; Anna Wood; Christine Connors; Jacqueline A. Boyle; Elizabeth Moore; Kerin O'Dea; Jeremy Oats; H. David McIntyre; Paul Zimmet; Jonathan E. Shaw; Maria E. Craig; Louise J. Maple-Brown

doi:10.1017/S2040174422000101

Hyperglycemia in pregnancy and developmental outcomes in children at 18-60 months of age: The PANDORA Wave 1 study

Angela Titmuss, Anita D'Aprano, Federica Barzi, Alex D.H. Brown, Anna Wood, Christine Connors, Jacqueline A. Boyle, Elizabeth Moore, Kerin O'Dea, Jeremy Oats, H. David McIntyre, Paul Zimmet, Jonathan E. Shaw, Maria E. Craig, Louise J. Maple-Brown

Research output: Contribution to journal › Article › peer-review

4 Citations (Scopus)

Abstract

This study aimed to explore the association between hyperglycemia in pregnancy (type 2 diabetes (T2D) and gestational diabetes mellitus (GDM)) and child developmental risk in Europid and Aboriginal women. PANDORA is a longitudinal birth cohort recruited from a hyperglycemia in pregnancy register, and from normoglycemic women in antenatal clinics. The Wave 1 substudy included 308 children who completed developmental and behavioral screening between age 18 and 60 months. Developmental risk was assessed using the Ages and Stages Questionnaire (ASQ) or equivalent modified ASQ for use with Aboriginal children. Emotional and behavioral risk was assessed using the Strengths and Difficulties Questionnaire. Multivariable logistic regression was used to assess the association between developmental scores and explanatory variables, including maternal T2D in pregnancy or GDM. After adjustment for ethnicity, maternal and child variables, and socioeconomic measures, maternal hyperglycemia was associated with increased developmental "concern"(defined as score ≥1 SD below mean) in the fine motor (T2D odds ratio (OR) 5.30, 95% CI 1.77-15.80; GDM OR 3.96, 95% CI 1.55-10.11) and problem-solving (T2D OR 2.71, 95% CI 1.05-6.98; GDM OR 2.54, 95% CI 1.17-5.54) domains, as well as increased "risk"(score ≥2 SD below mean) in at least one domain (T2D OR 5.33, 95% CI 1.85-15.39; GDM OR 4.86, 95% CI 1.95-12.10). Higher maternal education was associated with reduced concern in the problem-solving domain (OR 0.27, 95% CI 0.11-0.69) after adjustment for maternal hyperglycemia. Maternal hyperglycemia is associated with increased developmental concern and may be a potential target for intervention so as to optimize developmental trajectories.

Original language	English
Pages (from-to)	695-705
Number of pages	11
Journal	Journal of Developmental Origins of Health and Disease
Volume	13
Issue number	6
Early online date	4 Apr 2022
DOIs	https://doi.org/10.1017/S2040174422000101
Publication status	Published - 4 Dec 2022

Bibliographical note

Funding Information:
This work was supported by the National Health and Medical Research Council of Australia (NHMRC Grant no. 1078333) and the Channel 7 Children’s Research Foundation (#161329). AT was supported by a NHMRC Postgraduate Scholarship (#114760), RACP NHMRC Woolcock Scholarship and NHMRC Hot North PhD Completion Scholarship. LMB was supported by NHMRC Practitioner Fellowship no.1078477 and NHMRC Investigator Grant no. 1194698. JAB was supported by NHMRC Career Development Fellowship. JES was supported by NHMRC Fellowship no. 1079438. ADHB was supported by a Viertel Senior Medical Research Fellowship and an NHMRC Senior Research Fellowship no. 1137563. AW was supported by a NHMRC Postgraduate Scholarship. MC was supported by a NHMRC Practitioner fellowship no. 1136735. The funders had no role in study design, data collection and analysis, decision to publish or preparation of the manuscript.

Publisher Copyright:
© 2022 The Author(s). Published by Cambridge University Press in association with International Society for Developmental Origins of Health and Disease.

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Titmuss, A., D'Aprano, A., Barzi, F., Brown, A. D. H., Wood, A., Connors, C., Boyle, J. A., Moore, E., O'Dea, K., Oats, J., McIntyre, H. D., Zimmet, P., Shaw, J. E., Craig, M. E., & Maple-Brown, L. J. (2022). Hyperglycemia in pregnancy and developmental outcomes in children at 18-60 months of age: The PANDORA Wave 1 study. Journal of Developmental Origins of Health and Disease, 13(6), 695-705. https://doi.org/10.1017/S2040174422000101

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abstract = "This study aimed to explore the association between hyperglycemia in pregnancy (type 2 diabetes (T2D) and gestational diabetes mellitus (GDM)) and child developmental risk in Europid and Aboriginal women. PANDORA is a longitudinal birth cohort recruited from a hyperglycemia in pregnancy register, and from normoglycemic women in antenatal clinics. The Wave 1 substudy included 308 children who completed developmental and behavioral screening between age 18 and 60 months. Developmental risk was assessed using the Ages and Stages Questionnaire (ASQ) or equivalent modified ASQ for use with Aboriginal children. Emotional and behavioral risk was assessed using the Strengths and Difficulties Questionnaire. Multivariable logistic regression was used to assess the association between developmental scores and explanatory variables, including maternal T2D in pregnancy or GDM. After adjustment for ethnicity, maternal and child variables, and socioeconomic measures, maternal hyperglycemia was associated with increased developmental {"}concern{"}(defined as score ≥1 SD below mean) in the fine motor (T2D odds ratio (OR) 5.30, 95% CI 1.77-15.80; GDM OR 3.96, 95% CI 1.55-10.11) and problem-solving (T2D OR 2.71, 95% CI 1.05-6.98; GDM OR 2.54, 95% CI 1.17-5.54) domains, as well as increased {"}risk{"}(score ≥2 SD below mean) in at least one domain (T2D OR 5.33, 95% CI 1.85-15.39; GDM OR 4.86, 95% CI 1.95-12.10). Higher maternal education was associated with reduced concern in the problem-solving domain (OR 0.27, 95% CI 0.11-0.69) after adjustment for maternal hyperglycemia. Maternal hyperglycemia is associated with increased developmental concern and may be a potential target for intervention so as to optimize developmental trajectories.",

keywords = "child development, diabetes, Hyperglycemia, pregnancy",

author = "Angela Titmuss and Anita D'Aprano and Federica Barzi and Brown, {Alex D.H.} and Anna Wood and Christine Connors and Boyle, {Jacqueline A.} and Elizabeth Moore and Kerin O'Dea and Jeremy Oats and McIntyre, {H. David} and Paul Zimmet and Shaw, {Jonathan E.} and Craig, {Maria E.} and Maple-Brown, {Louise J.}",

note = "Funding Information: This work was supported by the National Health and Medical Research Council of Australia (NHMRC Grant no. 1078333) and the Channel 7 Children{\textquoteright}s Research Foundation (#161329). AT was supported by a NHMRC Postgraduate Scholarship (#114760), RACP NHMRC Woolcock Scholarship and NHMRC Hot North PhD Completion Scholarship. LMB was supported by NHMRC Practitioner Fellowship no.1078477 and NHMRC Investigator Grant no. 1194698. JAB was supported by NHMRC Career Development Fellowship. JES was supported by NHMRC Fellowship no. 1079438. ADHB was supported by a Viertel Senior Medical Research Fellowship and an NHMRC Senior Research Fellowship no. 1137563. AW was supported by a NHMRC Postgraduate Scholarship. MC was supported by a NHMRC Practitioner fellowship no. 1136735. The funders had no role in study design, data collection and analysis, decision to publish or preparation of the manuscript. Publisher Copyright: {\textcopyright} 2022 The Author(s). Published by Cambridge University Press in association with International Society for Developmental Origins of Health and Disease.",

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doi = "10.1017/S2040174422000101",

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Titmuss, A, D'Aprano, A, Barzi, F, Brown, ADH, Wood, A, Connors, C, Boyle, JA, Moore, E, O'Dea, K, Oats, J, McIntyre, HD, Zimmet, P, Shaw, JE, Craig, ME & Maple-Brown, LJ 2022, 'Hyperglycemia in pregnancy and developmental outcomes in children at 18-60 months of age: The PANDORA Wave 1 study', Journal of Developmental Origins of Health and Disease, vol. 13, no. 6, pp. 695-705. https://doi.org/10.1017/S2040174422000101

TY - JOUR

T1 - Hyperglycemia in pregnancy and developmental outcomes in children at 18-60 months of age

T2 - The PANDORA Wave 1 study

AU - Titmuss, Angela

AU - D'Aprano, Anita

AU - Barzi, Federica

AU - Brown, Alex D.H.

AU - Wood, Anna

AU - Connors, Christine

AU - Boyle, Jacqueline A.

AU - Moore, Elizabeth

AU - O'Dea, Kerin

AU - Oats, Jeremy

AU - McIntyre, H. David

AU - Zimmet, Paul

AU - Shaw, Jonathan E.

AU - Craig, Maria E.

AU - Maple-Brown, Louise J.

N1 - Funding Information: This work was supported by the National Health and Medical Research Council of Australia (NHMRC Grant no. 1078333) and the Channel 7 Children’s Research Foundation (#161329). AT was supported by a NHMRC Postgraduate Scholarship (#114760), RACP NHMRC Woolcock Scholarship and NHMRC Hot North PhD Completion Scholarship. LMB was supported by NHMRC Practitioner Fellowship no.1078477 and NHMRC Investigator Grant no. 1194698. JAB was supported by NHMRC Career Development Fellowship. JES was supported by NHMRC Fellowship no. 1079438. ADHB was supported by a Viertel Senior Medical Research Fellowship and an NHMRC Senior Research Fellowship no. 1137563. AW was supported by a NHMRC Postgraduate Scholarship. MC was supported by a NHMRC Practitioner fellowship no. 1136735. The funders had no role in study design, data collection and analysis, decision to publish or preparation of the manuscript. Publisher Copyright: © 2022 The Author(s). Published by Cambridge University Press in association with International Society for Developmental Origins of Health and Disease.

PY - 2022/12/4

Y1 - 2022/12/4

N2 - This study aimed to explore the association between hyperglycemia in pregnancy (type 2 diabetes (T2D) and gestational diabetes mellitus (GDM)) and child developmental risk in Europid and Aboriginal women. PANDORA is a longitudinal birth cohort recruited from a hyperglycemia in pregnancy register, and from normoglycemic women in antenatal clinics. The Wave 1 substudy included 308 children who completed developmental and behavioral screening between age 18 and 60 months. Developmental risk was assessed using the Ages and Stages Questionnaire (ASQ) or equivalent modified ASQ for use with Aboriginal children. Emotional and behavioral risk was assessed using the Strengths and Difficulties Questionnaire. Multivariable logistic regression was used to assess the association between developmental scores and explanatory variables, including maternal T2D in pregnancy or GDM. After adjustment for ethnicity, maternal and child variables, and socioeconomic measures, maternal hyperglycemia was associated with increased developmental "concern"(defined as score ≥1 SD below mean) in the fine motor (T2D odds ratio (OR) 5.30, 95% CI 1.77-15.80; GDM OR 3.96, 95% CI 1.55-10.11) and problem-solving (T2D OR 2.71, 95% CI 1.05-6.98; GDM OR 2.54, 95% CI 1.17-5.54) domains, as well as increased "risk"(score ≥2 SD below mean) in at least one domain (T2D OR 5.33, 95% CI 1.85-15.39; GDM OR 4.86, 95% CI 1.95-12.10). Higher maternal education was associated with reduced concern in the problem-solving domain (OR 0.27, 95% CI 0.11-0.69) after adjustment for maternal hyperglycemia. Maternal hyperglycemia is associated with increased developmental concern and may be a potential target for intervention so as to optimize developmental trajectories.

AB - This study aimed to explore the association between hyperglycemia in pregnancy (type 2 diabetes (T2D) and gestational diabetes mellitus (GDM)) and child developmental risk in Europid and Aboriginal women. PANDORA is a longitudinal birth cohort recruited from a hyperglycemia in pregnancy register, and from normoglycemic women in antenatal clinics. The Wave 1 substudy included 308 children who completed developmental and behavioral screening between age 18 and 60 months. Developmental risk was assessed using the Ages and Stages Questionnaire (ASQ) or equivalent modified ASQ for use with Aboriginal children. Emotional and behavioral risk was assessed using the Strengths and Difficulties Questionnaire. Multivariable logistic regression was used to assess the association between developmental scores and explanatory variables, including maternal T2D in pregnancy or GDM. After adjustment for ethnicity, maternal and child variables, and socioeconomic measures, maternal hyperglycemia was associated with increased developmental "concern"(defined as score ≥1 SD below mean) in the fine motor (T2D odds ratio (OR) 5.30, 95% CI 1.77-15.80; GDM OR 3.96, 95% CI 1.55-10.11) and problem-solving (T2D OR 2.71, 95% CI 1.05-6.98; GDM OR 2.54, 95% CI 1.17-5.54) domains, as well as increased "risk"(score ≥2 SD below mean) in at least one domain (T2D OR 5.33, 95% CI 1.85-15.39; GDM OR 4.86, 95% CI 1.95-12.10). Higher maternal education was associated with reduced concern in the problem-solving domain (OR 0.27, 95% CI 0.11-0.69) after adjustment for maternal hyperglycemia. Maternal hyperglycemia is associated with increased developmental concern and may be a potential target for intervention so as to optimize developmental trajectories.

KW - child development

KW - diabetes

KW - Hyperglycemia

KW - pregnancy

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DO - 10.1017/S2040174422000101

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AN - SCOPUS:85128351000

SN - 2040-1744

VL - 13

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EP - 705

JO - Journal of Developmental Origins of Health and Disease

JF - Journal of Developmental Origins of Health and Disease

IS - 6

ER -

Hyperglycemia in pregnancy and developmental outcomes in children at 18-60 months of age: The PANDORA Wave 1 study

Abstract

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