Academic Achievement in Primary School in Offspring Born to Mothers With Type 1 Diabetes (the EPICOM Study): A Register-Based Prospective Cohort Study

作者：Knorr Sine^*; Clausen Tine D; Vlachova Zuzana; Bytoft Birgitte; Damm Peter; Beck Nielsen Henning; Jensen Dorte M; Juul Svend; Gravholt Claus Hojbjerg

来源：Diabetes Care, 2015, 38(7): 1238-1244.

DOI：10.2337/dc15-0223

OBJECTIVEThis study examined the effect of maternal pregestational type 1 diabetes on offspring primary school performance.RESEARCH DESIGN AND METHODSWe performed a prospective combined clinical and register-based cohort study comparing primary school performance in offspring (n = 707) of women with pregestational type 1 diabetes with matched control offspring (n = 60,341). We also examined the association between HbA(1c) levels during pregnancy and later school performance among offspring born to women with pregestational type 1 diabetes.RESULTSOffspring of mothers with pregestational type 1 diabetes obtained similar school grades as control offspring when finishing primary school (regression coefficient [] = -0.13; 95% CI = -0.30 to 0.03; P = 0.12). Adjusting for parental education also resulted in an insignificant difference between the two groups ( = -0.07; 95% CI = -0.23 to 0.09; P = 0.37). Among offspring of women with type 1 diabetes, increasing maternal HbA(1c) pregestationally and throughout the pregnancy was associated with lower average school grades. Offspring born to mothers with good glycemic control in the third trimester obtained higher average school grades compared with control offspring. The opposite applied to offspring born to mothers with inadequate glycemic control, who obtained significantly lower average school grades compared with control offspring.CONCLUSIONSOffspring of mothers with pregestational type 1 diabetes obtained similar average grades when finishing primary school compared with matched control offspring. Among offspring of women with type 1 diabetes, we found a consistent negative association between maternal HbA(1c) in pregnancy and primary school grades. However, whether this association reflects a direct causal influence of intrauterine hyperglycemia is uncertain.

• 出版日期2015-7