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Cognitive and Motor Development in 3- to 6-Year-Old Children Born to Mothers with Hyperglycaemia First Detected in Pregnancy in an Urban African Population

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Abstract

Objectives

Hyperglycaemia first detected in pregnancy (HFDP), on the rise in urban sub-Saharan Africa (SSA), may negatively impact foetal neurodevelopment, with potential long-term cognitive consequences for the child. Data on this association from SSA is lacking, and we aimed to investigate the association in 3- to 6-year-old children in Soweto, South Africa.

Methods

In this comparative study, we compared cognitive skills measured with the Herbst Early Childhood Development Criteria test in 95 children born to mothers with HFDP and 99 participants unexposed to maternal HFDP. Fine and gross motor skills were secondary outcomes. Ordinal regression analysis with known confounders was performed for children born at-term.

Results

Of children exposed to HFDP born at-term, 24.3% scored ‘high’ and 25.7% scored ‘low’ in the cognitive subsection of the test, as opposed to 37.7% and 12.9% in the HFDP-unexposed group, respectively. In ordinal regression, exposed participants had a significantly lower odds of scoring in a higher cognitive category when adjusting for maternal confounders and socio-economic status (OR 0.33, 95% CI 0.15–0.74, p = 0.007). No difference was found in gross motor development between the two groups; differences in fine motor development were attenuated after adjustment for maternal pregnancy factors and household socioeconomic status (OR 0.62, 95% CI 0.28–1.37, p = 0.239).

Conclusions for Practice

Exposure to HFDP was negatively associated with cognitive development at preschool age. Optimising maternal (preconception) health and early childhood cognitive stimulation could help more children reach their developmental potential.

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Data Availability

Data is available upon request to the corresponding author.

Code Availability

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Funding

This study was supported through SAN by the South African Medical Research Council, and SAN is also supported by the DST-NRF Centre of Excellence in Human Development at the University of the Witwatersrand, Johannesburg.

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Authors and Affiliations

  1. Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Stratenum 6.131, P.O Box 85500, 3508 GA, Utrecht, The Netherlands

    L. M. Soepnel & K. Klipstein-Grobusch

  2. SAMRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa

    L. M. Soepnel, V. Nicolaou, C. E. Draper & S. A. Norris

  3. Chronic Disease Initiative for Africa, Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa

    N. S. Levitt

  4. Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa

    K. Klipstein-Grobusch

  5. Global Health Research Institute, School of Human Development and Health, University of Southampton, Southampton, UK

    S. A. Norris

Authors
  1. L. M. Soepnel
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  2. V. Nicolaou
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  3. C. E. Draper
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  4. N. S. Levitt
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  5. K. Klipstein-Grobusch
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  6. S. A. Norris
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Contributions

SAN, KKG, NSL, VN, CED and LMS contributed to research conceptualization and planning. VN and LMS contributed to the study project coordination and data collection. CD advised on the use of the Herbst test. LMS performed data analysis and wrote the initial manuscript version. All the authors contributed to interpretation of data and revising the manuscript. All authors approved the final submitted version of the manuscript.

Corresponding author

Correspondence to L. M. Soepnel.

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Conflict of interest

Authors have no conflict of interest to declare.

Ethical Approval

Ethical approval for this study was obtained from the Human Research Ethics Committee of the University of the Witwatersrand (ref: M180317), and the study was therefore performed in accordance with the 1964 Declaration of Helsinki and its amendments.

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Written informed consent was obtained from the participants’ parent or guardian prior to participation in the study. Any details that might disclose the identity of the participants were omitted.

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Not applicable.

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Soepnel, L.M., Nicolaou, V., Draper, C.E. et al. Cognitive and Motor Development in 3- to 6-Year-Old Children Born to Mothers with Hyperglycaemia First Detected in Pregnancy in an Urban African Population. Matern Child Health J 26, 1328–1338 (2022). https://doi.org/10.1007/s10995-021-03331-z

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