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Effect of parental obesity and gestational diabetes on child neuropsychological and behavioral development at 4 years of age: the Rhea mother–child cohort, Crete, Greece

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Abstract

Studies have suggested an association between maternal obesity pre-pregnancy and gestational diabetes (GDM) with impaired offspring neurodevelopment, but it is not clear if these associations are explained by shared familiar characteristics. We aimed to assess the associations of maternal and paternal obesity, maternal glucose intolerance in early pregnancy and GDM, with offspring neurodevelopment at 4 years of age. We included 772 mother–child pairs from the “Rhea” Mother–Child cohort in Crete, Greece. Data on maternal/paternal body mass index (BMI) and maternal fasting serum samples for glucose and insulin measurements were collected at 12 weeks of gestation. GDM screening was performed at 24–28 weeks. Neurodevelopment at 4 years was assessed using the McCarthy Scales of Children’s Abilities. Behavioral difficulties were assessed by Strengths and Difficulties Questionnaire and Attention Deficit Hyperactivity Disorder Test. Multivariate linear regression analyses showed that maternal obesity was associated with a significant score reduction in general cognitive ability (β-coeff −4.03, 95% CI: −7.08, −0.97), perceptual performance (β-coeff −4.60, 95% CI: −7.74, −1.47), quantitative ability (β-coeff −4.43, 95% CI: −7.68, −1.18), and executive functions (β-coeff −4.92, 95% CI: −8.06, −1.78) at 4 years of age, after adjustment for several confounders and paternal BMI. Maternal obesity was also associated with increased behavioral difficulties (β-coeff 1.22, 95% CI: 0.09, 2.34) and ADHD symptoms (β-coeff 4.28, 95% CI: 1.20, 7.36) at preschool age. Paternal obesity maternal glucose intolerance in early pregnancy and GDM was not associated with child neurodevelopment. These findings suggest that maternal obesity may impair optimal child neurodevelopment at preschool age independently of family shared characteristics.

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Abbreviations

ADHD:

Attention Deficit Hyperactivity Disorder

AGA:

Appropriate for gestational age

BMI:

Body mass index

CI:

Confidence interval

GAMs:

Generalized additive models

GDM:

Gestational diabetes mellitus

IOM:

Institute of Medicine

IQ:

Intelligence quotient

LGA:

Large for gestational age

MSCA:

McCarthy Scales of Children’s Abilities

SDQ:

Strengths and Difficulties Questionnaire

SD:

Standard deviation

SGA:

Small for gestational age

TSH:

Thyroid stimulating hormone

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Acknowledgements

The authors would particularly like to thank all the cohort participants for their generous collaboration. The Rhea project was financially supported from European research grants and the Greek Ministry of Health.

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Authors and Affiliations

  1. Department of Social Medicine, Faculty of Medicine, University of Crete, PO Box 2208, 71003, Heraklion, Crete, Greece

    Vasiliki Daraki, Theano Roumeliotaki, Katerina Koutra, Vaggelis Georgiou, Mariza Kampouri, Andriani Kyriklaki, Marina Vafeiadi & Leda Chatzi

  2. Department of Endocrinology, Diabetes and Metabolic Diseases, University Hospital of Crete, Heraklion, Crete, Greece

    Vasiliki Daraki & Stathis Papavasiliou

  3. Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain

    Manolis Kogevinas

  4. Department of Genetics and Cell Biology, Faculty of Health, Medicine and Life Sciences, Maastricht University, Universiteitssingel 40, PO Box 616, 6229 ER, Maastricht, The Netherlands

    Leda Chatzi

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  1. Vasiliki Daraki
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Correspondence to Vasiliki Daraki.

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Daraki, V., Roumeliotaki, T., Koutra, K. et al. Effect of parental obesity and gestational diabetes on child neuropsychological and behavioral development at 4 years of age: the Rhea mother–child cohort, Crete, Greece. Eur Child Adolesc Psychiatry 26, 703–714 (2017). https://doi.org/10.1007/s00787-016-0934-2

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