Diabetic Environment During Gestation Increases Risk for Psychiatric Disorders

Pregnant woman is using a glucometer at home.
Individuals who were exposed to maternal diabetes in utero were at increased risk for psychiatric disorders during the first 4 decades of life.

Individuals who were exposed to maternal diabetes in utero were at increased risk for psychiatric disorders during the first 4 decades of life. These findings were published in JAMA Network Open.

Data were sourced from nationwide registries of Denmark. All live births between 1978 and 2016 (N=2,413,335) were assessed for exposure to pregestational diabetes mellitus (PGDM) and gestational diabetes mellitus (GDM) and eventual diagnosis of psychiatric disorders.

A total of 56,206 live births were exposed to type 1 PGDM (n=22,614), type 2 PGDM (n=6713), and GDM (n=26,879) and 2,357,129 were unexposed. The study population was 51.3% boys or men aged median 19.0 (range, 1-39) years.

A total of 6.4% of the population received a diagnosis of a psychiatric disorder. The incident rate of a psychiatric disorder was increased among the type 1 PGDM (38.0 per 10,000 person years [py]), type 2 PGDM (42.1 per 10,000 py), and GDM (36.5 per 10,000 py) cohorts compared with the unexposed group (35.8 per 10,000 py).

Exposure increased risk for any disorder (adjusted hazard ratio [aHR], 1.15; 95% CI, 1.10-1.20), schizophrenia (aHR, 1.55; 95% CI, 1.15-2.08), anxiety disorders (aHR, 1.22; 95% CI, 1.09-1.36), intellectual disabilities (aHR, 1.29; 95% CI, 1.11-1.50), developmental disorders (aHR, 1.16; 95% CI, 1.03-1.30), and behavioral disorders (aHR, 1.17; 95% CI, 1.08-1.27).

Stratified by type of exposure, risk was highest among the GDM cohort for any psychiatric disorder (aHR, 1.18), schizophrenia (aHR, 1.88), anxiety disorders (aHR, 1.34), and behavioral disorders (aHR, 1.18); was highest among the type 1 PGDM cohort for intellectual disabilities (aHR, 1.35); and was highest among the type 2 PGDM cohort for developmental disorders (aHR, 1.51).

No associations were observed between diabetes exposure and personality disorders (aHR, 1.09; 95% CI, 0.71-1.65), eating disorders (aHR, 1.21; 95% CI, 0.98-1.50), mood disorders (aHR, 1.12; 95% CI, 0.90-1.39), or substance use disorders (aHR, 0.99; 95% CI, 0.91-1.08).

This study was limited by not having access to additional information about lifestyle factors.

These data indicated that risk for psychiatric disorders was increased among individuals who had prenatal exposure to diabetes, highlighting the importance of managing symptoms of diabetes during pregnancy.

Disclosure: An author declared affiliations with industry. Please refer to the original article for a full list of disclosures.

Reference

Avelar e Siva RN, Yu Y, Liew Z, Vested A, Sørensen T, Li J. Associations of Maternal Diabetes During Pregnancy With Psychiatric Disorders in Offspring During the First 4 Decades of Life in a Population-Based Danish Birth Cohort.JAMA Netw Open. Published online October 14, 2021. doi:10.1001/jamanetworkopen.2021.28005