title: Effect of parental obesity and gestational diabetes on child neuropsychological and behavioral development at 4 years of age: the Rhea mother-child cohort, Crete, Greece.
abstract: Studies have suggested an association between maternal obesity pre-pregnancy and gestational diabetes (GDM) with impaired offspring neurodevelopment, but it is not clear if these associations are explained by shared familiar characteristics. We aimed to assess the associations of maternal and paternal obesity, maternal glucose intolerance in early pregnancy and GDM, with offspring neurodevelopment at 4 years of age. We included 772 mother-child pairs from the "Rhea" Mother-Child cohort in Crete, Greece. Data on maternal/paternal body mass index (BMI) and maternal fasting serum samples for glucose and insulin measurements were collected at 12 weeks of gestation. GDM screening was performed at 24-28 weeks. Neurodevelopment at 4 years was assessed using the McCarthy Scales of Children's Abilities. Behavioral difficulties were assessed by Strengths and Difficulties Questionnaire and Attention Deficit Hyperactivity Disorder Test. Multivariate linear regression analyses showed that maternal obesity was associated with a significant score reduction in general cognitive ability (β-coeff -4.03, 95% CI: -7.08, -0.97), perceptual performance (β-coeff -4.60, 95% CI: -7.74, -1.47), quantitative ability (β-coeff -4.43, 95% CI: -7.68, -1.18), and executive functions (β-coeff -4.92, 95% CI: -8.06, -1.78) at 4 years of age, after adjustment for several confounders and paternal BMI. Maternal obesity was also associated with increased behavioral difficulties (β-coeff 1.22, 95% CI: 0.09, 2.34) and ADHD symptoms (β-coeff 4.28, 95% CI: 1.20, 7.36) at preschool age. Paternal obesity maternal glucose intolerance in early pregnancy and GDM was not associated with child neurodevelopment. These findings suggest that maternal obesity may impair optimal child neurodevelopment at preschool age independently of family shared characteristics.
authors.affiliation: Department of Social Medicine, Faculty of Medicine, University of Crete, PO Box 2208, 71003, Heraklion, Crete, Greece. darvas72@yahoo.gr.|Department of Endocrinology, Diabetes and Metabolic Diseases, University Hospital of Crete, Heraklion, Crete, Greece. darvas72@yahoo.gr.
authors.forename: Vasiliki
authors.identifier: http://orcid.org/0000-0003-1764-4913
authors.initials: V
authors.lastname: Daraki
authors.affiliation: Department of Social Medicine, Faculty of Medicine, University of Crete, PO Box 2208, 71003, Heraklion, Crete, Greece.
authors.forename: Theano
authors.initials: T
authors.lastname: Roumeliotaki
authors.affiliation: Department of Social Medicine, Faculty of Medicine, University of Crete, PO Box 2208, 71003, Heraklion, Crete, Greece.
authors.forename: Katerina
authors.initials: K
authors.lastname: Koutra
authors.affiliation: Department of Social Medicine, Faculty of Medicine, University of Crete, PO Box 2208, 71003, Heraklion, Crete, Greece.
authors.forename: Vaggelis
authors.initials: V
authors.lastname: Georgiou
authors.affiliation: Department of Social Medicine, Faculty of Medicine, University of Crete, PO Box 2208, 71003, Heraklion, Crete, Greece.
authors.forename: Mariza
authors.initials: M
authors.lastname: Kampouri
authors.affiliation: Department of Social Medicine, Faculty of Medicine, University of Crete, PO Box 2208, 71003, Heraklion, Crete, Greece.
authors.forename: Andriani
authors.initials: A
authors.lastname: Kyriklaki
authors.affiliation: Department of Social Medicine, Faculty of Medicine, University of Crete, PO Box 2208, 71003, Heraklion, Crete, Greece.
authors.forename: Marina
authors.initials: M
authors.lastname: Vafeiadi
authors.affiliation: Department of Endocrinology, Diabetes and Metabolic Diseases, University Hospital of Crete, Heraklion, Crete, Greece.
authors.forename: Stathis
authors.initials: S
authors.lastname: Papavasiliou
authors.affiliation: Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain.
authors.forename: Manolis
authors.initials: M
authors.lastname: Kogevinas
authors.affiliation: Department of Social Medicine, Faculty of Medicine, University of Crete, PO Box 2208, 71003, Heraklion, Crete, Greece.|Department of Genetics and Cell Biology, Faculty of Health, Medicine and Life Sciences, Maastricht University, Universiteitssingel 40, PO Box 616, 6229 ER, Maastricht, The Netherlands.
authors.forename: Leda
authors.initials: L
authors.lastname: Chatzi
mesh_terms: D002675:Child, Preschool; D015331:Cohort Studies; D016640:Diabetes, Gestational / Q000523:psychology*; D005260:Female; D006115:Greece; D006801:Humans; D008297:Male; D009035:Mothers; D009765:Obesity / Q000150:complications*; D011247:Pregnancy; D012307:Risk Factors
keywords: Behavior; Gestational diabetes; Longitudinal study; Neuropsychological development; Obesity; Preschool age