Gestational Diabetes Mellitus and Childhood Neurodevelopment Disorders in Offspring-Results from a Large Multi-racial/ethnic Cohort Study

Objectives: Gestational diabetes mellitus (GDM) has been linked to a higher risk of certain neurodevelopmental disorders (NDDs) such as autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD) in offspring; however, other types of NDDs are rarely studied and whether the associations vary by race/ethnicity remains unknown. Thus, we aimed to examine the association of GDM with different types of NDDs and by race/ethnicity. Methods: This retrospective cohort study included 14,480 singletons born to mothers without pre-existing diabetes and were followed to at least 1 year old in a large medical system in the US from 3/1/2013 to 8/31/2021. We ascertained GDM using the International Classification of Disease (ICD) codes (ICD-9: 648.8x; ICD-10: O24.4x) and defined NDDs (speech/language disorder [SLD], developmental coordination disorder [DCD], ASD, and others [ADHD, behavioral disorder, intellectual disability, and learning difficulty]) using validated algorithms. We compared the risk of NDDs during the entire follow-up period between offspring born to mothers with GDM and without GDM using multivariable Cox regression models. Results: During the median of 3.2 years (interquartile range: 2.0-4.9) follow-up period, GDM was significantly associated with a higher risk of SLD (adjusted hazard ratio: 1.62; 95% CI: 1.10, 2.40), DCD (2.35; 95% CI: 1.38, 4.02), ASD (3.28; 95% CI: 1.42, 7.58), and other NDDs (3.20; 95% CI: 1.55, 6.60) among children born to non-Hispanic White mothers. No significant association of GDM with any type of NDDs was observed among other race/ethnicity. Conclusion: Young children born to non-Hispanic White mothers with GDM had an elevated risk of NDDs. However, the results may be affected by differential outcome misclassification by race/ethnicity. Disclosure X.Liu: None. C.Janzen: None. M.Seamans: None. R.Nianogo: None. Z.Fei: None. L.Chen: None.