Children born to mothers with any diabetes type in Ontario, Canada, had a higher risk of developing epilepsy.For children of mothers with type 1 or type 2 diabetes, epilepsy risk tended to rise with longer diabetes duration.Kids exposed to maternal diabetes during gestation may need closer monitoring for early signs of epilepsy.
Children born to mothers with any diabetes subtype had an increased risk of epilepsy, a retrospective Canadian study showed.
Compared with unexposed children, epilepsy risk was higher over 10.2 years of follow-up for kids exposed to one of three types of maternal diabetes during gestation, reported Bénédicte Driollet, PhD, of McGill University in Montreal, and colleagues:
Type 2 diabetes: adjusted HR 1.40, 95% CI 1.24-1.58Type 1 diabetes: adjusted HR 1.32, 95% CI 1.03-1.69Gestational diabetes: adjusted HR 1.14, 95% CI 1.07-1.22
“Our study strengthens the hypothesis that prenatal factors may contribute to the onset of epilepsy in children, and that one such factor could be exposure to maternal diabetes during pregnancy,” Driollet told MedPage Today.
The findings, detailed in Pediatrics, suggest that children exposed to maternal diabetes in utero may benefit from closer clinical monitoring for early signs of epilepsy, she added.
Elevated epilepsy risk may reflect that maternal diabetes is tied to pregnancy complications, such as caesarean section, preterm birth, congenital anomalies, preeclampsia, or macrosomia, which are also linked with epilepsy in offspring.
“These complications may act as potential mediators in the association between maternal diabetes and epilepsy risk, though this study did not formally assess mediation pathways,” the researchers wrote.
Few studies have previously examined maternal diabetes and childhood epilepsy, despite diabetes being a common comorbidity during pregnancy.
“In the literature, maternal diabetes has been associated with adverse neurodevelopmental outcomes in offspring, but evidence linking it to epilepsy remains limited and inconsistent,” Driollet observed.
A 2024 meta-analysis found no link between gestational diabetes and childhood epilepsy, for example, but other studies supported an association between type 1 or type 2 diabetes and increased epilepsy risks, the researchers noted.
“To our knowledge, this study was the first study conducted in North America to be interested in the association between the diagnosis of epilepsy in children and all maternal diabetes subtypes, pre-gestational and gestational, and to evaluate the possible impact of prolonged maternal diabetes,” Driollet said.
“Further investigation of this association is now warranted, particularly by examining the underlying mechanisms, such as assessing the effect of diabetes mediated through different pregnancy complications on the risk of epilepsy,” she added.
The study identified 2,188,175 children — 7.6% of whom were exposed to maternal diabetes — born in Ontario hospitals between April 2002 and December 2018. Overall, 6.1% were exposed to gestational diabetes, 1.2% were exposed to type 2 diabetes, and 0.3% were exposed to type 1 diabetes.
During follow-up, 17,853 children were diagnosed with epilepsy, half of whom were diagnosed by age 3 years. Epilepsy was defined as at least one inpatient hospitalization diagnosis or three or more outpatient diagnoses.
Pregestational diabetes tended to be associated with epilepsies diagnosed at younger ages, while gestational diabetes appeared to be linked with increased epilepsy risk mostly in adolescence.
Longer durations of maternal type 1 or type 2 diabetes were associated with increased epilepsy risk in offspring. “While we expected more pronounced differences related to prolonged maternal diabetes, the results still suggested a higher risk of epilepsy with longer exposure,” Driollet noted.
Study limitations included a lack of information about epilepsy subtypes. In addition, the study relied on administrative data based on hospitalizations and physician billing claims, the researchers acknowledged.
