Low glucose challenge test result as a potential risk factor for delays in early child development: the Japan environment and children's study.

Objectives: To clarify the relationship between maternal 50-g glucose challenge test (GCT) results and neurodevelopment in 3-year-old children and determine if low GCT results are linked to early neurodevelopmental delays in offspring.

Methods: In this nationwide prospective cohort study, we extracted data from 104,062 foetal records from the Japan Environment and Children's Study. Outcomes comprised developmental status cut-off values for the domains of the Ages and Stages Questionnaire, Third Edition. The exclusion criteria were gestational diabetes mellitus, diabetes during pregnancy, and GCT results ≥ 140 mg/dL. Based on these criteria, we included 12,472 women who had undergone a GCT between 14 and 27 weeks of gestation and divided the participants into a low-GCT group (cohort specific ≤ 10th percentile, ≤ 81 mg/dL) and a non-low-GCT group (82-139 mg/dL). Multivariable logistic regression analysis was used to investigate the association between low GCT results and early neurodevelopmental delays.

Results: Compared with infants born to women with normal GCT results, those born to women with low GCT results showed a significantly higher incidence of neurodevelopmental delays, particularly in communication, gross motor, fine motor, and problem-solving skills (adjusted odds ratio [OR] 1.35, 95% confidence interval [CI] 1.02-1.78; adjusted OR 1.31, 95% CI 1.01-1.69; adjusted OR 1.26, 95% CI 1.02-1.56; adjusted OR 1.24, 95% CI 1.01-1.54, respectively). No significant increase in the adjusted ORs (95% CIs) was observed for female offspring.

Conclusions: Low maternal GCT results are associated with offspring neurodevelopment at 3 years of age, with the association influenced by offspring sex.

Supplementary information: The online version contains supplementary material available at 10.1007/s40200-025-01568-x.