Children of diabetic mothers may be at more risk of developing multiple sclerosis (MS), a Danish national study suggests.
The study, “Maternal diabetes and risk of multiple sclerosis in the offspring: A Danish nationwide register-based cohort study,” was published in the Multiple Sclerosis Journal.
Previous studies have suggested a three to 10 times increased risk of MS among children born to women with diabetes mellitus — a disease in which blood sugar levels are too high. However, these findings still need to be confirmed.
To shed light on this matter, researchers in Denmark explored the possible mechanism underlying the association between maternal diabetes — diagnosed before conception (pregestational) or during pregnancy (gestational) — and the risk of MS in their children.
Because a possible association between maternal diabetes and the risk of MS in children might reflect shared genetic or environmental risk factors rather than the effects of diabetic exposure during pregnancy, the researchers also examined the risk of MS among children of diabetic fathers.
The nationwide study included 1,633,436 singleton babies born in Denmark from 1978–2008. MS diagnoses were identified in the Danish Multiple Sclerosis Registry, and parental diabetes diagnoses in the National Patient Register. Data was analyzed using appropriate statistical models.
A total of 2,332 cases of MS, 1,634 of which were female, were identified. In an initial analysis, the risk of MS was found to be significantly associated with maternal obesity (65%) and birth weight.
The team identified 16,979 children born to diabetic mothers, 6,809 of whom were diagnosed before pregnancy and 10,170 diagnosed during pregnancy, and 8,239 children of diabetic fathers.
In an analysis adjusted for factors such as age and sex, as well as maternal and paternal age and maternal obesity, the MS risk among children with diabetic mothers was 63% higher than those with nondiabetic mothers.
Children whose mothers had pregestational diabetes were at a 2.3 times higher risk of MS, whereas MS risk was not statistically significant among children of mothers with gestational diabetes or diabetic fathers.
The team also analyzed the risk of MS in children of parents diagnosed with autoimmune diseases other than MS or diabetes (25,598 mothers, 17,316 fathers). They found that, overall, these children were not at a significant risk of developing MS — 1.4 times higher for maternal exposure and 1.01 times higher for paternal exposure.
However, the risk of MS in children who were exposed to maternal pregestational autoimmune diseases did approach statistical significance, at 1.54 times higher.
Specifically, children born to mothers with pregestational inflammatory bowel disease (IBD) – a chronic gastrointestinal inflammatory disorder – were at a 2.12 times increased risk of MS. Nonetheless, neither children of fathers with IBD nor those from mothers with gestational IBD were at any unusual risk of MS (1.42 and 0.93 times, respectively).
The researchers noted several limitations to their study as it included a limited number of MS cases, and the Danish National Patient Register has incomplete information concerning obesity. Furthermore, since men are less likely to have a diabetes diagnosis than pregnant women, this could lead to data underestimation, misclassification, and overly conservative risk estimates.
“Based on high-quality national register data in Denmark, our large cohort study corroborates the view that maternal [diabetes] is associated with an increased risk of MS in the offspring,” the researchers concluded.
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