Sex-specific association of maternal glycaemia with the preschooler cognitive development in a prospective cohort study: “the higher the worse?”

Abstract

Abstract Objective: To estimate the association of maternal FPG and x-hPG in different periods of pregnancy as continuum with preschooler’s intellectual development, and explored more deeply whether these associations differ between sex and GDM status. Methods: This study was based on 2,157 mother-offspring dyads from the Ma’anshan birth cohort (MABC) study. Multivariate linear and logistic regression were used to explore the association between maternal glycaemia and preschoolers’ intelligent development. In addition, stratified analyses according to fetus's sex and GDM status were performed. Results: After adjusting for covariates, we found that for each 1 mmol/L increase in 1-hPG, 2-hPG, AUC concentration during the second trimester, the scores of FSIQ in preschoolers increased by 0.341 (95%CI: 0.058, 0.624), 0.416 (95%CI: 0.041, 0.792), 0.258 (95%CI: 0.042, 0.474) points, respectively. When stratified by the GDM status and fetus’s sex, the positive associations were only observed in the non-GDM group [OR(95%CI)= 0.702(0.085, 1.318); 0.610 (0.080, 1.139); 0.341(0.032, 0.651)], and among girls, 1 mmol/L increments of 1-hPG and AUC concentration was found to be associated with 22% and 19% lower odds of intelligence development retardation (95% CI: 0.623, 0.974; 95% CI: 0.678, 0.973). Conclusions: Our study found trimester-, GDM status-, and sex-specific positive associations between maternal glycaemia with preschoolers’ cognition development, which suggested that higher normal maternal glycaemia levels may benefit offspring’s cognitive development. Our finding implies the clinical importance of revisiting the concept of “the higher maternal glycaemic the worse cognitive development” and further exploration of sex-specific mechanisms of maternal glycaemic on fetus brain development.