Study suggests gestational diabetes raises ADHD risk

Young children are apparently more likely to develop attentional and hyperactivity issues if the mother develops diabetes during pregnancy, says a new study published this week in the Archives of Pediatrics and Adolescent Medicine.

The study discovered a tentative link between ADHD in young children and a diagnosis of gestational (pregnancy-induced) diabetes in mothers who carried them. They were twice as likely as their peers to meet the criteria for attention deficit hyperactivity disorder (ADHD) by the time they reached their sixth birthday.

Children who lived in families with below-average socioeconomic status also exhibited a two-fold risk for developing ADHD by the age of six, but children who had both risk factors had a whopping fourteen-fold increased risk for developing the handicap, compared to peers without either risk factor. This comparison clearly demonstrates that ADHD has both exogenous (outside) risk factors as well as endogenous (inside, or within the child’s body) ones.

Researchers stopped short of naming gestational diabetes as the cause of ADHD, but they are helping to highlight the fact that gestational diabetes may pose hidden dangers to a child well after birth, especially if the child grows up in a challenging environment.

Yoko Nomura, Ph.D., the lead author of the study and an assistant clinical professor of psychiatry at the Mount Sinai School of Medicine, in New York City, says gestational diabetes is a serious health issue. "Mothers should be aware that gestational diabetes can affect her fetus," she writes.

The message is all the more important as more and more women are diagnosed with the condition.

Gestational diabetes generally develops during the second or third trimester of pregnancy -- the same window of time in which a fetus undergoes a critical burst of brain development. The condition affects roughly 5% of pregnant women in the U.S.

Gestational diabetes is characterized by abnormally high sugar in the blood. Fetuses who are bombarded by this excess sugar are physiologically challenged to “manage” that excess. The excess is managed by increased weight in the baby (such babies may weigh ten pounds at birth) and by diverting the extra sugar out of the fetal environment. The problem, Nomura explains, is that the central nervous system is co-opted by the process, thereby inhibiting certain vital developmental steps. As a result, the central nervous system may not develop properly.

Growing up poor may only exacerbate the situation. "When babies are born into higher socioeconomic status households, they have better access to medical care [and] remedial activities, intellectual stimulus is higher, they have better foods," says Nomura.

In tandem with poorer access to health care, mothers who live in poverty are less likely to treat their gestational diabetes.

The study was limited by the small number of participants and by the fact that researchers did not collect ADHD data on the children’s siblings or other relatives. Also, whether or not mothers controlled their gestational diabetes was not figured into the analysis.

Nevertheless, the study is an important reminder that a child’s environment – whether inside or outiide of the womb – is an important shaper of future potential.

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