A large international study has found that children born to mothers with gestational diabetes face a higher likelihood of developing attention deficit–hyperactivity disorder (ADHD) and autism spectrum disorder (ASD). The research, presented last week at the European Association for the Study of Diabetes meeting in Vienna, analyzed more than nine million pregnancies across 20 countries and is currently under review at a peer-reviewed journal.
The study combined results from 48 investigations and revealed that children whose mothers had gestational diabetes during pregnancy had lower average IQ scores, a 36% higher risk of ADHD, and a 56% higher risk of autism compared with children of mothers without the condition. Researchers stress, however, that the findings indicate association rather than causation. “There’s no doubt that there is a signal here, but certainly further research is required,” says Alex Polyakov, an obstetrician and researcher at the University of Melbourne in Australia.
A Growing Body of Evidence
This is not the first time gestational diabetes has been linked to neurodevelopmental disorders. A separate meta-analysis published in The Lancet Diabetes & Endocrinology in June, which examined 56 million mother–child pairs, also found that diabetes in pregnancy — whether type 1, type 2, or gestational — increased the risk of both ADHD and autism.
Despite these consistent findings, none of the studies prove that diabetes during pregnancy directly causes neurodevelopmental conditions. Genetics remains the strongest predictor of ADHD and autism, but environmental factors such as folic acid deficiency, air pollution, and gestational diabetes can also influence risk. “In practice, both genetic predisposition and environmental factors likely interact,” says Polyakov.
Health Impacts Beyond Pregnancy
Gestational diabetes is already known to have long-term health consequences for mothers, including an increased risk of type 2 diabetes, heart disease, stroke, and kidney disease. The latest research suggests that its effects may extend to children’s neurocognitive development as well.
Ling-Jun Li, a clinician–scientist at the National University of Singapore and co-author of the study, says that most of the studies reviewed showed a link between gestational diabetes and either ADHD or autism. While some studies found no such connection, Li notes that many had small sample sizes, making it harder to detect significant effects.
Questions Still to Be Answered
Experts caution that other factors could help explain the association. Women with gestational diabetes often have higher rates of obesity, smoking, or lower socioeconomic status — all of which could contribute to developmental risks. Indeed, an international study last year involving 3.6 million mother–child pairs suggested that increased ADHD risk was seen in siblings regardless of whether their mother had gestational diabetes, indicating that the condition itself may not be the root cause.
Polyakov says more nuanced research is needed, particularly studies comparing outcomes in children born to mothers with mild versus severe gestational diabetes. “That could show whether gestational diabetes actually influences risk,” he explains.
For now, the findings add to a growing body of evidence that gestational diabetes may play a role — though not a decisive one — in shaping children’s neurodevelopment.
