Impact of Early Gestational Maternal Fasting Plasma Glucose on Developmental Delays at Age Two
Overview
This cohort study of 1541 mother–child pairs found no association between maternal fasting plasma glucose (mFPG) levels in early gestation and developmental delays in children at age two. Notably, low mFPG levels (≤70 mg/dL) were associated with a decreased risk of developmental delay across five domains compared to moderate levels (71–94 mg/dL).
Background
Developmental delay in children involves lagging in communication, social, and daily living skills and may precede disorders such as autism spectrum disorder (ASD). Maternal hyperglycemia, including gestational diabetes mellitus (GDM), has been linked to neurodevelopmental issues in offspring, but prior studies mostly focused on diagnosed diabetes rather than continuous glucose levels. Early gestation is a critical period for fetal brain development, and maternal fasting plasma glucose (mFPG) is routinely measured during prenatal care, making it a clinically relevant exposure to study. This research aimed to clarify the relationship between early gestational mFPG and developmental delay at two years of age.
Data Highlights
Measure
Value
Sample size (mother–child pairs)
1541
Prevalence of mFPG ≥95 mg/dL
5.2%
Prevalence of developmental delay at 2 years
15.1%
Adjusted odds ratio (aOR) for developmental delay per unit mFPG increase
1.004 (95% CI: 0.990–1.018)
aOR for developmental delay with mFPG ≤70 mg/dL vs 71–94 mg/dL
0.464 (95% CI: 0.229–0.943)
Key Findings
Maternal fasting plasma glucose (mFPG) measured before 24 weeks gestation was not associated with increased risk of developmental delay in children at age two when analyzed as a continuous variable.
Children of mothers with low mFPG levels (≤70 mg/dL) had a significantly lower risk of developmental delay across five domains compared to those with mFPG levels between 71 and 94 mg/dL.
No significant association was found between high mFPG levels (≥95 mg/dL) and developmental delays in any domain.
Overall, 15.1% of children at two years exhibited developmental delays as assessed by the Ages and Stages Questionnaire.
The study excluded mothers with pre-existing diabetes or gestational diabetes and controlled for confounders using multiple logistic regression.
Clinical Implications
Routine measurement of maternal fasting plasma glucose in early gestation may not predict developmental delays in offspring at two years of age. Low maternal glucose levels do not appear harmful and may be associated with reduced developmental risk, suggesting that early gestational glucose within normal or low ranges is not detrimental to neurodevelopment. Clinicians should continue standard prenatal glucose monitoring but consider that early mFPG alone is not a strong indicator for developmental delay risk.
Conclusion
Early gestational maternal fasting plasma glucose levels were not associated with increased developmental delays in children at age two. These findings support the current clinical practice of glucose monitoring without additional concern for neurodevelopmental outcomes based solely on early pregnancy glucose levels.
References
Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study -- Impact of Early Gestational Maternal Fasting Plasma Glucose on Developmental Delays in Children at Age Two
A large Swedish cohort found cardiometabolic biomarkers measured up to decades before pregnancy were associated with hypertensive disorders — with risk apparent even below standard diagnostic thresholds.
