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. 2019 Mar 12:15:675-684.
doi: 10.2147/NDT.S189200. eCollection 2019.

The association of maternal diabetes with attention deficit and hyperactivity disorder in offspring: a meta-analysis

Lifeng Zhao  1 , Xuesong Li  2 , Guanying Liu  1 , Baoling Han  1 , Jian Wang  1 , Xia Jiang  1
Affiliations
Free PMC article

The association of maternal diabetes with attention deficit and hyperactivity disorder in offspring: a meta-analysis

Lifeng Zhao et al. Neuropsychiatr Dis Treat. .
Free PMC article

Abstract

Objective: Recent controversial evidence suggests that maternal diabetes may increase the risk of attention deficit and hyperactivity disorder (ADHD) in offspring. To examine this potential association, a systematic literature search and meta-analysis was performed.

Methods: OR or risk ratio (RR) from each study was obtained and combined for evaluating the risk. Six cohort studies and three case-control studies were included in the present study.

Results: The meta-analysis of the highly heterogeneous case-control studies did not find significant association between maternal diabetes and ADHD risk (OR: 1.20, 95% CI: 0.96-1.49). The combining of the cohort studies demonstrated that offspring of diabetic mothers were at higher risk of ADHD (RR: 1.40, 95% CI: 1.27-1.54); however, publication bias was identified. When exposure was specified as gestational diabetes mellitus (GDM), GDM exposure increased the risk of ADHD for children by 164% (95% CI: 1.25-5.56) in a Caucasian population. Neither heterogeneity nor publication bias was detected.

Conclusion: Maternal diabetes, especially GDM, is probably a risk factor for ADHD in the Caucasian population. More studies based on large sample size and different ethnicities are needed to confirm this association.

Keywords: attention deficit hyperactivity disorder; maternal diabetes; meta-analysis.

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Conflict of interest statement

Disclosure The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Flow diagram of the identification of the eligible studies.
Figure 2
Figure 2
Main results of the meta-analyses. Notes: (A) Data combination of case-control studies; (B) sensitivity analysis on case-control studies; (C) data combination of cohort studies; and (D) sensitivity analysis on cohort studies. Weights are from random-effects analysis. Abbreviations: ES, effect size; GDM, gestational diabetes mellitus; T1D, type 1 diabetes; T2D, type 2 diabetes.
Figure 3
Figure 3
Meta-analyses of the subjects from (A) mothers with GDM or (B) Caucasian mothers with GDM. Abbreviations: ES, effect size; GDM, gestational diabetes mellitus.
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