P0724 - Diabetes during Pregnancy is Associated with Concern for Developmental Delay in Offspring

Background
Maternal glucose intolerance during pregnancy has been associated with developmental delays and impairments in offspring including worse motor function and a greater likelihood of inattention and/or hyperactivity. The First Baby Study recruited an observational cohort 3006 women during their first pregnancy and followed maternal-child dyads for 3 years. We sought to evaluate associations between diabetes during pregnancy and subjective concern for developmental delay among offspring at ages 6 and 12 months.

Methods
Participants between the ages of 18 and 35 who were expecting their first child were recruited from76 hospitals in Pennsylvania in 2009-2011. Birth certificate and medical record data were obtained in addition to survey data. A woman was categorized as having diabetes if pregestational and/or gestational diabetes were reported in the hospital discharge or birth certificate data. The participants were asked “Has a doctor or health care provider been concerned about your baby’s development?” at 6 and 12 months postpartum. Multiple logistic regression models were built to test associations in the data.

Results
There were 2,910 women who completed the 6-month postpartum interview, among whom 6.3% (n=184) had a diabetes diagnosis and 3.1% (n=91) reported clinician concern about their child’s development. There were 2,801 women who completed the 12-month interview, among whom 6.5% (n=182) had a diabetes diagnosis and 3.5% (n=99) reported clinician concern about their child’s development. After controlling for maternal age, education, race/ethnicity, poverty, insurance coverage, pre-pregnancy body mass index, gestational weight gain, mode of delivery, hypertension, gestational age, 5-minute Apgar score, and childbirth complications for the mother and newborn, diabetes in pregnancy was associated with maternal report of clinician concern about child development at both 6 months (OR=2.20, 95% CI=1.10-4.42, p=.026) and 12 months of age (OR=3.93, 95% CI=2.13-7.26, p<.0001).

Conclusions
In this large-scale prospective study of first childbirth mother-child dyads diabetes during pregnancy was associated with maternal report of clinician concerns about child development at both 6 and 12 months of age after controlling for pertinent covariates. Further research is needed to better understand the association between diabetes during pregnancy and child development.