The risk of intellectual disability in offspring of diabetic mothers: A systematic review and meta-analysis

Epidemiological evidence on association between maternal diabetes and intellectual disability (ID) in offspring is mixed. This systematic review and meta-analysis aimed to synthesise the existing evidence to determine the extent and nature of this association. We systematically searched Embase, Web of Science, Scopus, PubMed, PsycINFO, and CINAHL databases from inception to March 14, 2023. The methodological quality of the included studies was assessed using the Newcastle-Ottawa Scale. Effect estimates for each exposure-outcome association were synthesised using a random-effects model Sensitivity and subgroup analyses were performed to identify potential sources of heterogeneity. A total of ten studies, comprising 8,927,706 mother-child pairs, met the inclusion criteria. Our analyses revealed that children exposed to any form of maternal diabetes had higher odds of ID compared to unexposed counterparts. Specifically, we found a 61 % higher risk of ID in offspring of mothers with any pre-existing diabetes. However, no significant association was found between gestational diabetes mellitus (GDM) and ID risk in offspring. The present meta-analysis suggests that exposure to pre-existing type 1 diabetes (T1D) and type 2 diabetes (T2D), but not GDM, is associated with increased risks of ID in offspring. Further high-quality studies, adequately adjusted for potential confounders, are needed to confirm these findings.