Neurodevelopmental trajectories in well-controlled gestational diabetes mellitus offspring: no differences were found at the 6-and 12-month assessments

Jing PengHuazhang MiaoLi ZhangJing JinLirong HeDongdong XueYong Guo^*Guocheng Liu^*

• Guangdong women and children hospital, Guangzhou, China

Objective: To examine the associations between well-controlled gestational diabetes mellitus (GDM) and early neurodevelopmental trajectories in offspring. Methods: This retrospective cohort study included 2810 mother‒infant pairs from Guangdong Women and Children Hospital (2016--2022). GDM was diagnosed via a 75 g oral glucose tolerance test at 24–28 gestational weeks, and women with well-controlled GDM were those who maintained blood glucose levels defined as a third-trimester HbA1c < 6% without requiring medication. Neurodevelopment was assessed via the Children's Neuropsychological and Behavioral Scale-Revision 2016 at 6 and 12 months of age. Results: Among 2810 mother‒infant pairs, 451 (16.05%) were diagnosed with GDM. Compared with non-GDM mothers, mothers with GDM had a greater median age (31.00 vs. 29.00 years; P < 0.001) and prepregnancy BMI (21.26 vs. 20.20 kg/m²; P < 0.001). No significant differences were observed in neonatal sex, birth weight or low birth weight (<2500 g) proportions. Neurodevelopmental assessments at 6 and 12 months revealed no significant differences in gross motor, fine motor, or adaptive behavior; language; or personal‒social scores (all P > 0.05). Adjusted multivariate analyses revealed no associations between GDM and neurodevelopmental delay (≥2 subdomains below the threshold) at 6 months (OR = 0.92, 95% CI: 0.57–1.48; P = 0.739) or 12 months (OR = 0.87, 95% CI: 0.58–1.29; P = 0.479). Conclusions: Well-controlled GDM was not associated with adverse neurodevelopmental outcomes in early infancy, suggesting that optimized perinatal management may mitigate risks.