(585) Association Between Treatment Modalities for Gestational Diabetes Mellitus and Risk of Attention-Deficit/Hyperactivity Disorder in Offspring

The association between gestational diabetes mellitus (GDM) and long-term neurodevelopmental disorders (NDD), particularly attention-deficit/hyperactivity disorder (ADHD), remains a topic of debate. We aimed to explore the association between GDM, either dietary controlled (GDMA1) or pharmacologic treated (GDMA2) and the risk of ADHD in the offspring.

Study Design:

Retrospective population-based study included all deliveries in "Clalit" HMO hospitals from 2012 to 2020. Women with unknown diabetic status during pregnancy or with pregestational diabetes were excluded from the study. Offspring were followed through electronic medical records starting at age 4 years.

Results: Among 15,074 children exposed to maternal GDM (13,566 GDMA1, 1,508 GDMA2) and 187,112 children born to mothers with normal glycemic index (control group), 13,446 were diagnosed with ADHD, median age was 6.5 years with interquartile range (IQR) 2.15 years. The incidence of ADHD was significantly higher in the GDM groups compared to 6.6% in the control group; 7.4% (pV< 0.001) in the GDMA1 group, and 8.5% (pV< 0.001) in the GDMA2 group. The adjusted odds ratios (aOR) for ADHD were 1.30 (95% CI: 1.06-1.57, p=0.008) for children exposed to GDMA2 and 1.09 (95% CI: 1.01-1.16, p=0.02) for those exposed to GDMA1, compared to unexposed children. Additionally, gestational hypertension during pregnancy was identified as a significant risk factor for ADHD, with an aOR of 1.19 (95% CI: 1.003-1.39, p=0.04).

Conclusion: Maternal GDM significantly increases the risk of ADHD in exposed offspring. The need for pharmacologic intervention to control gestational diabetes further amplifies this risk.