Article

Diabetologia

, Volume 57, Issue 1, pp 102-109

First online:

Open Access This content is freely available online to anyone, anywhere at any time.

Maternal diabetes in pregnancy and offspring cognitive ability: sibling study with 723,775 men from 579,857 families

  • Abigail FraserAffiliated withMRC Integrative Epidemiology Unit at the University of Bristol Email author 
  • , Catarina AlmqvistAffiliated withDepartment of Medical Epidemiology and Biostatistics, Karolinska InstitutetLung and Allergy Unit, Astrid Lindgren Children’s Hospital, Karolinska University Hospital
  • , Henrik LarssonAffiliated withDepartment of Medical Epidemiology and Biostatistics, Karolinska Institutet
  • , Niklas LångströmAffiliated withDepartment of Medical Epidemiology and Biostatistics, Karolinska Institutet
  • , Debbie A. LawlorAffiliated withMRC Integrative Epidemiology Unit at the University of Bristol

Abstract

Aims/hypothesis

The aim of this study was to investigate the association between maternal diabetes in pregnancy and offspring cognitive ability and also to assess whether the association was due to intrauterine mechanisms or shared familial characteristics.

Methods

We linked national registers and conducted a prospective cohort study of singleton Swedish-born men to explore associations between maternal pregnancy diabetes and educational achievement at age 16 years, the age of completing compulsory education in Sweden (n = 391,545 men from 337,174 families, graduating in 1988–1997 and n = 326,033 men from 282,079 families, graduating in 1998–2009), and intelligence quotient (IQ) at the mandatory conscription examination at 18 years of age (n = 664,871 from 543,203 families).

Results

Among non-siblings, maternal diabetes in pregnancy was associated with lower offspring cognitive ability even after adjustment for maternal age at birth, parity, education, early-pregnancy BMI, offspring birth year, gestational age and birthweight. For example, in non-siblings, the IQ of men whose mothers had diabetes in their pregnancy was on average 1.36 points lower (95% CI −2.12, −0.60) than men whose mothers did not have diabetes. In comparison, we found no such association within sibships (mean difference 1.70; 95% CI −1.80, 5.21).

Conclusions/interpretation

The association between maternal diabetes in pregnancy and offspring cognitive outcomes is likely explained by shared familial characteristics and not by an intrauterine mechanism.

Keywords

Cognition Diabetes IQ Pregnancy Sibling comparison Swedish registers