Cognitive and motor development in 3- to 6-year-old children born to mothers with hyperglycaemia first detected in pregnancy in an urban African population
Cognitive and motor development in 3- to 6-year-old children born to mothers with hyperglycaemia first detected in pregnancy in an urban African population
Objectives: hyperglycaemia first detected in pregnancy (HFDP), on the rise in urban sub-Saharan Africa (SSA), may negatively impact foetal neurodevelopment, with potential long-term cognitive consequences for the child. Data on this association from SSA is lacking, and we aimed to investigate the association in 3- to 6-year-old children in Soweto, South Africa.
Methods: in this comparative study, we compared cognitive skills measured with the Herbst Early Childhood Development Criteria test in 95 children born to mothers with HFDP and 99 participants unexposed to maternal HFDP. Fine and gross motor skills were secondary outcomes. Ordinal regression analysis with known confounders was performed for children born at-term.
Results: of children exposed to HFDP born at-term, 24.3% scored ‘high’ and 25.7% scored ‘low’ in the cognitive subsection of the test, as opposed to 37.7% and 12.9% in the HFDP-unexposed group, respectively. In ordinal regression, exposed participants had a significantly lower odds of scoring in a higher cognitive category when adjusting for maternal confounders and socio-economic status (OR 0.33, 95% CI 0.15–0.74, p = 0.007). No difference was found in gross motor development between the two groups; differences in fine motor development were attenuated after adjustment for maternal pregnancy factors and household socioeconomic status (OR 0.62, 95% CI 0.28–1.37, p = 0.239).
Conclusions for Practice: exposure to HFDP was negatively associated with cognitive development at preschool age. Optimising maternal (preconception) health and early childhood cognitive stimulation could help more children reach their developmental potential.
Cognitive development, Early childhood development, Gestational diabetes, Hyperglycaemia in pregnancy, Sub-Saharan Africa
1328-1338
Soepnel, L.M.
5a89deee-06a8-4a04-b4e6-cae60b0350f1
Nicolaou, V.
ce74335b-4acd-47ec-946b-eb926c7762f0
Draper, C.E.
5032d1f5-0c2a-44be-8bdb-6e4967d49e14
Levitt, N.S.
c1505788-1df6-40df-b0bb-79fe9d53f93f
Klipstein-Grobusch, K.
3ad61933-41fc-4d32-83de-6e86af6d9fe9
Norris, S.A.
1d346f1b-6d5f-4bca-ac87-7589851b75a4
June 2022
Soepnel, L.M.
5a89deee-06a8-4a04-b4e6-cae60b0350f1
Nicolaou, V.
ce74335b-4acd-47ec-946b-eb926c7762f0
Draper, C.E.
5032d1f5-0c2a-44be-8bdb-6e4967d49e14
Levitt, N.S.
c1505788-1df6-40df-b0bb-79fe9d53f93f
Klipstein-Grobusch, K.
3ad61933-41fc-4d32-83de-6e86af6d9fe9
Norris, S.A.
1d346f1b-6d5f-4bca-ac87-7589851b75a4
Soepnel, L.M., Nicolaou, V., Draper, C.E., Levitt, N.S., Klipstein-Grobusch, K. and Norris, S.A.
(2022)
Cognitive and motor development in 3- to 6-year-old children born to mothers with hyperglycaemia first detected in pregnancy in an urban African population.
Maternal and Child Health Journal, 26 (6), .
(doi:10.1007/s10995-021-03331-z).
Abstract
Objectives: hyperglycaemia first detected in pregnancy (HFDP), on the rise in urban sub-Saharan Africa (SSA), may negatively impact foetal neurodevelopment, with potential long-term cognitive consequences for the child. Data on this association from SSA is lacking, and we aimed to investigate the association in 3- to 6-year-old children in Soweto, South Africa.
Methods: in this comparative study, we compared cognitive skills measured with the Herbst Early Childhood Development Criteria test in 95 children born to mothers with HFDP and 99 participants unexposed to maternal HFDP. Fine and gross motor skills were secondary outcomes. Ordinal regression analysis with known confounders was performed for children born at-term.
Results: of children exposed to HFDP born at-term, 24.3% scored ‘high’ and 25.7% scored ‘low’ in the cognitive subsection of the test, as opposed to 37.7% and 12.9% in the HFDP-unexposed group, respectively. In ordinal regression, exposed participants had a significantly lower odds of scoring in a higher cognitive category when adjusting for maternal confounders and socio-economic status (OR 0.33, 95% CI 0.15–0.74, p = 0.007). No difference was found in gross motor development between the two groups; differences in fine motor development were attenuated after adjustment for maternal pregnancy factors and household socioeconomic status (OR 0.62, 95% CI 0.28–1.37, p = 0.239).
Conclusions for Practice: exposure to HFDP was negatively associated with cognitive development at preschool age. Optimising maternal (preconception) health and early childhood cognitive stimulation could help more children reach their developmental potential.
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More information
Accepted/In Press date: 21 November 2021
e-pub ahead of print date: 8 January 2022
Published date: June 2022
Additional Information:
Funding Information:
This study was supported through SAN by the South African Medical Research Council, and SAN is also supported by the DST-NRF Centre of Excellence in Human Development at the University of the Witwatersrand, Johannesburg.
Keywords:
Cognitive development, Early childhood development, Gestational diabetes, Hyperglycaemia in pregnancy, Sub-Saharan Africa
Identifiers
Local EPrints ID: 476584
URI: http://eprints.soton.ac.uk/id/eprint/476584
ISSN: 1092-7875
PURE UUID: 55c2c9a7-7c23-4b57-b812-6ff6c36d134c
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Date deposited: 09 May 2023 16:48
Last modified: 16 Apr 2024 01:57
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Contributors
Author:
L.M. Soepnel
Author:
V. Nicolaou
Author:
C.E. Draper
Author:
N.S. Levitt
Author:
K. Klipstein-Grobusch
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