A multinational cohort study, which included a research team in Taiwan, has found no clear link between maternal diabetes during pregnancy and attention deficit hyperactivity disorder (ADHD) in children, challenging previous studies, the National Science and Technology Council (NSTC) said yesterday.
About 16 percent of pregnant women worldwide experience hyperglycemia (high blood sugar levels), and the prevalence of diabetes during pregnancy has been increasing due to obesity and older maternal age, raising calls for more attention on the risks associated with maternal diabetes and neurodevelopment in children, the study said.
Some studies have suggested that children born to mothers who had diabetes during pregnancy are at significantly increased risk of developing ADHD.
Photo: Wu Po-hsuan, Taipei Times
However, the new multinational cohort study — which used data on more than 3.6 million mother-child pairs in Taiwan, Finland, Hong Kong, Iceland, New Zealand, Norway and Sweden from 2001 to 2014, with follow-ups on the subjects until 2020 — found that the link between maternal diabetes and child ADHD might not be causal.
National Cheng Kung University School of Pharmacy professor Edward Lai (賴嘉鎮), who led the research team in Taiwan, reported their findings at the NSTC, which has supported the research for several years.
Many studies suggested that gestational diabetes might be linked to ADHD in offspring, but that conclusion could be based on previous studies’ limitations, including limited sample sizes, low ethnical diversity, relying on a single database, and overlooking some confounders such as shared genetics and environmental factors, Lai said
The extensive multinational study, conducted by international researchers of the Neurological and Mental Health Global Epidemiology Network, had a large sample size, multinational database with racial diversity, and improved the study design by adding sibling-control analysis and controlling other unmeasured confounding factors, he said.
Researchers found that children who were born to mothers with any type of diabetes during pregnancy had a slightly higher risk of ADHD than other children, but after considering the intricate interplay of different influential factors, no clear causal link exists, he said.
When comparing the development of ADHD between siblings with different exposure to gestational diabetes, they found no significant difference, which indicates that the association is likely influenced by genetic and familial factors, rather than caused by gestational diabetes itself, he said.
Disorders in children are often blamed on the health of their mother during pregnancy, but the study’s findings helped clarified that misconception, NSTC Department of Life Sciences Director-General Young Tai-horng (楊台鴻) said, adding that its sample size of 3.6 million was difficult to achieve.
The causes of ADHD are still unclear, but other hypotheses point to genetics, risk exposure during pregnancy, preterm birth and other environmental factors, Lai said.
The study also suggested that future research should explore the specific roles of genetic factors and glycemic control during different stages of embryonic brain development in humans.
The study’s findings were published in the international peer-reviewed biomedical research journal Nature Medicine in April.
Additional reporting by Wu Po-hsuan
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