ECHO Researchers Investigate Associations Between Gestational Diabetes, Perinatal Maternal Depression, and Early Childhood Behavioral Problems

Collaborative ECHO research led by Lauren C. Shuffrey, PhD of Columbia University investigates the effects of gestational diabetes, a type of diabetes that mothers develop during pregnancy, prenatal depression, and postpartum depression on early childhood behavior. This study found gestational diabetes, prenatal maternal depressive symptoms, and postnatal maternal depressive symptoms were each independently linked to higher levels of externalizing and internalizing behavior problems during early childhood. The study also found that gestational diabetes was only associated with autism-related behaviors when children were exposed to higher levels of perinatal maternal depressive symptoms. Finally, maternal gestational diabetes was only associated with child behavioral problems for male children.

This research, titled “Association of Gestational Diabetes Mellitus and Perinatal Maternal Depression with Early Childhood Behavioral Problems: An Environmental Influences on Child Health Outcomes (ECHO) Study” is published in Child Development.

Although previous research has shown associations between gestational diabetes and pre- and postnatal depression in mothers, prior studies have not determined if the combination of these conditions affect child behavioral outcomes.

This study included 2,379 children from ECHO cohorts located in Colorado, Massachusetts, New York, Pennsylvania, and Tennessee. More than half of child participants (52%) were male, and 216 participants were born to mothers with gestational diabetes during pregnancy.

More than half of maternal participants were from an underrepresented minority group with 32% self-identifying as Black, 23% as Hispanic, 15% as Mixed Race, and 4% as Asian.

In this study, ECHO researchers used the Preschool Child Behavior Checklist (CBCL) to examine the behavior of children ages 2 to 5 years old. The researchers also collected information from the mothers, including gestational diabetes diagnosis and self-assessments of depression symptoms during and after pregnancy. The study evaluated how gestational diabetes, prenatal depression, and postpartum depression affected children’s behavioral outcomes using the CBCL.

“Our findings suggest that children born to mothers who had both gestational diabetes and symptoms of depression during pregnancy could benefit from receiving additional monitoring for behavioral problems during early childhood,” said Dr. Shuffrey. “Future research should investigate potential biological mechanisms underlying associations between gestational diabetes, maternal depression, and early childhood behavioral outcomes.”

Read the research summary.