School performance in Danish children exposed to maternal type 1 diabetes in utero: A nationwide retrospective cohort study
Conflicting results have been reported concerning possible adverse effects on the cognitive function of offspring of mothers with type 1 diabetes (O-mT1D). Previous studies have included offspring of parents from the background population (O-BP), but not offspring of fathers with type 1 diabetes (O-...
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| creator | Spangmose, Anne Lærke Skipper, Niels Knorr, Sine Wullum Gundersen, Tina Beck Jensen, Rikke Damm, Peter Lykke Mortensen, Erik Pinborg, Anja Svensson, Jannet Clausen, Tine |
| description | Conflicting results have been reported concerning possible adverse effects on the cognitive function of offspring of mothers with type 1 diabetes (O-mT1D). Previous studies have included offspring of parents from the background population (O-BP), but not offspring of fathers with type 1 diabetes (O-fT1D) as the unexposed reference group.
This is a population-based retrospective cohort study from 2010 to 2016. Nationally standardized school test scores (range, 1 to 100) were obtained for public school grades 2, 3, 4, 6, and 8 in O-mT1D and compared with those in O-fT1D and O-BP. Of the 622,073 included children, 2,144 were O-mT1D, and 3,474 were O-fT1D. Multiple linear regression models were used to compare outcomes, including the covariates offspring with type 1 diabetes, parity, number of siblings, offspring sex, smoking during pregnancy, parental age, and socioeconomic factors. Mean test scores were 54.2 (standard deviation, SD 24.8) in O-mT1D, 54.4 (SD 24.8) in O-fT1D, and 56.4 (SD 24.7) in O-BP. In adjusted analyses, the mean differences in test scores were -1.59 (95% CI -2.48 to -0.71, p < 0.001) between O-mT1D and O-BP and -0.78 (95% CI -1.48 to -0.08, p = 0.03) between O-fT1D and O-BP. No significant difference in the adjusted mean test scores was found between O-mT1D and O-fT1D (p = 0.16). The study's limitation was no access to measures of glycemic control during pregnancy.
O-mT1D achieved lower test scores than O-BP but similar test scores compared with O-fT1D. Glycemic control during pregnancy is essential to prevent various adverse pregnancy outcomes in women with type 1 diabetes. However, the present study reduces previous concerns regarding adverse effects of in utero hyperglycemia on offspring cognitive function. |
| doi_str_mv | 10.1371/journal.pmed.1003977 |
| format | Article |
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This is a population-based retrospective cohort study from 2010 to 2016. Nationally standardized school test scores (range, 1 to 100) were obtained for public school grades 2, 3, 4, 6, and 8 in O-mT1D and compared with those in O-fT1D and O-BP. Of the 622,073 included children, 2,144 were O-mT1D, and 3,474 were O-fT1D. Multiple linear regression models were used to compare outcomes, including the covariates offspring with type 1 diabetes, parity, number of siblings, offspring sex, smoking during pregnancy, parental age, and socioeconomic factors. Mean test scores were 54.2 (standard deviation, SD 24.8) in O-mT1D, 54.4 (SD 24.8) in O-fT1D, and 56.4 (SD 24.7) in O-BP. In adjusted analyses, the mean differences in test scores were -1.59 (95% CI -2.48 to -0.71, p < 0.001) between O-mT1D and O-BP and -0.78 (95% CI -1.48 to -0.08, p = 0.03) between O-fT1D and O-BP. No significant difference in the adjusted mean test scores was found between O-mT1D and O-fT1D (p = 0.16). The study's limitation was no access to measures of glycemic control during pregnancy.
O-mT1D achieved lower test scores than O-BP but similar test scores compared with O-fT1D. Glycemic control during pregnancy is essential to prevent various adverse pregnancy outcomes in women with type 1 diabetes. However, the present study reduces previous concerns regarding adverse effects of in utero hyperglycemia on offspring cognitive function.</description><identifier>ISSN: 1549-1676</identifier><identifier>ISSN: 1549-1277</identifier><identifier>EISSN: 1549-1676</identifier><identifier>DOI: 10.1371/journal.pmed.1003977</identifier><identifier>PMID: 35472047</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Academic achievement ; Academic Performance ; Achievement tests ; Birth weight ; Child ; Children ; Cognitive ability ; Cohort analysis ; Cohort Studies ; Complications and side effects ; Demographic aspects ; Denmark - epidemiology ; Diabetes ; Diabetes mellitus (insulin dependent) ; Diabetes Mellitus, Type 1 - epidemiology ; Elementary school students ; Father and child ; Female ; Genetic aspects ; Gestational age ; Health aspects ; Humans ; Hyperglycemia ; Insulin ; Medicine and Health Sciences ; Mother and child ; Obstetrics ; Offspring ; People and places ; Population studies ; Pregnancy ; Prenatal Exposure Delayed Effects - epidemiology ; Private schools ; Public schools ; Reading ; Regression analysis ; Retrospective Studies ; Side effects ; Social Sciences ; Socioeconomic factors ; Type 2 diabetes</subject><ispartof>PLoS medicine, 2022-04, Vol.19 (4), p.e1003977-e1003977</ispartof><rights>COPYRIGHT 2022 Public Library of Science</rights><rights>2022 Spangmose et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2022 Spangmose et al 2022 Spangmose et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c694t-4359ad584f0a3ac1bc5d817065c46cc954e22dee772ca2b296171ce6380302ce3</citedby><cites>FETCH-LOGICAL-c694t-4359ad584f0a3ac1bc5d817065c46cc954e22dee772ca2b296171ce6380302ce3</cites><orcidid>0000-0002-2067-5246 ; 0000-0002-8340-104X ; 0000-0001-7541-5858 ; 0000-0001-6552-5340 ; 0000-0002-4522-672X ; 0000-0002-9365-0728 ; 0000-0002-6985-451X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9041831/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9041831/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2095,2914,23846,27903,27904,53769,53771,79346,79347</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35472047$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Persson, Lars Åke</contributor><creatorcontrib>Spangmose, Anne Lærke</creatorcontrib><creatorcontrib>Skipper, Niels</creatorcontrib><creatorcontrib>Knorr, Sine</creatorcontrib><creatorcontrib>Wullum Gundersen, Tina</creatorcontrib><creatorcontrib>Beck Jensen, Rikke</creatorcontrib><creatorcontrib>Damm, Peter</creatorcontrib><creatorcontrib>Lykke Mortensen, Erik</creatorcontrib><creatorcontrib>Pinborg, Anja</creatorcontrib><creatorcontrib>Svensson, Jannet</creatorcontrib><creatorcontrib>Clausen, Tine</creatorcontrib><title>School performance in Danish children exposed to maternal type 1 diabetes in utero: A nationwide retrospective cohort study</title><title>PLoS medicine</title><addtitle>PLoS Med</addtitle><description>Conflicting results have been reported concerning possible adverse effects on the cognitive function of offspring of mothers with type 1 diabetes (O-mT1D). Previous studies have included offspring of parents from the background population (O-BP), but not offspring of fathers with type 1 diabetes (O-fT1D) as the unexposed reference group.
This is a population-based retrospective cohort study from 2010 to 2016. Nationally standardized school test scores (range, 1 to 100) were obtained for public school grades 2, 3, 4, 6, and 8 in O-mT1D and compared with those in O-fT1D and O-BP. Of the 622,073 included children, 2,144 were O-mT1D, and 3,474 were O-fT1D. Multiple linear regression models were used to compare outcomes, including the covariates offspring with type 1 diabetes, parity, number of siblings, offspring sex, smoking during pregnancy, parental age, and socioeconomic factors. Mean test scores were 54.2 (standard deviation, SD 24.8) in O-mT1D, 54.4 (SD 24.8) in O-fT1D, and 56.4 (SD 24.7) in O-BP. In adjusted analyses, the mean differences in test scores were -1.59 (95% CI -2.48 to -0.71, p < 0.001) between O-mT1D and O-BP and -0.78 (95% CI -1.48 to -0.08, p = 0.03) between O-fT1D and O-BP. No significant difference in the adjusted mean test scores was found between O-mT1D and O-fT1D (p = 0.16). The study's limitation was no access to measures of glycemic control during pregnancy.
O-mT1D achieved lower test scores than O-BP but similar test scores compared with O-fT1D. Glycemic control during pregnancy is essential to prevent various adverse pregnancy outcomes in women with type 1 diabetes. However, the present study reduces previous concerns regarding adverse effects of in utero hyperglycemia on offspring cognitive function.</description><subject>Academic achievement</subject><subject>Academic Performance</subject><subject>Achievement tests</subject><subject>Birth weight</subject><subject>Child</subject><subject>Children</subject><subject>Cognitive ability</subject><subject>Cohort analysis</subject><subject>Cohort Studies</subject><subject>Complications and side effects</subject><subject>Demographic aspects</subject><subject>Denmark - epidemiology</subject><subject>Diabetes</subject><subject>Diabetes mellitus (insulin dependent)</subject><subject>Diabetes Mellitus, Type 1 - epidemiology</subject><subject>Elementary school students</subject><subject>Father and child</subject><subject>Female</subject><subject>Genetic aspects</subject><subject>Gestational age</subject><subject>Health aspects</subject><subject>Humans</subject><subject>Hyperglycemia</subject><subject>Insulin</subject><subject>Medicine and Health Sciences</subject><subject>Mother and child</subject><subject>Obstetrics</subject><subject>Offspring</subject><subject>People and places</subject><subject>Population studies</subject><subject>Pregnancy</subject><subject>Prenatal Exposure Delayed Effects - epidemiology</subject><subject>Private schools</subject><subject>Public schools</subject><subject>Reading</subject><subject>Regression analysis</subject><subject>Retrospective Studies</subject><subject>Side effects</subject><subject>Social Sciences</subject><subject>Socioeconomic factors</subject><subject>Type 2 diabetes</subject><issn>1549-1676</issn><issn>1549-1277</issn><issn>1549-1676</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>DOA</sourceid><recordid>eNqVk11rFDEUhgdRbK3-A9GAIHqxa74mM_FCKPWrUCxY9TZkkzM7KbOTaZKpLf55M-62dGUvlFwkJM_7nuScnKJ4SvCcsIq8Ofdj6HU3H1Zg5wRjJqvqXrFPSi5nRFTi_p31XvEoxnOMqcQSPyz2WMkrinm1X_w6M633HRogND6sdG8AuR69172LLTKt62yAHsHV4CNYlDxa6QRTYJSuB0AEWacXkCBOsjEf-bfoEPU6Od__dBZQgBR8HMAkdwnI-NaHhGIa7fXj4kGjuwhPNvNB8f3jh29Hn2cnp5-Ojw5PZkZInmaclVLbsuYN1kwbsjClrUmFRWm4MEaWHCi1AFVFjaYLKgWpiAHBaswwNcAOiudr36HzUW3yFhUVoiSMi5y6g-J4TVivz9UQ3EqHa-W1U382fFgqHZIzHSgua2obIURFNCfY1FRSKtlC2oWkYHn2ereJNi5yaQz0Kehuy3T7pHetWvpLJTEnNSPZ4NXGIPiLEWJSKxcNdJ3uwY_TvUtBpGSszuiLv9Ddr9tQS50f4PrG57hmMlWHFaalpKSavGY7qCX0kC_pe2hc3t7i5zv4PCysnNkpeL0lyEyCq7TUY4zq-Ozrf7Bf_p09_bHNvrzDtqC71EbfjdNvjdsgX4Mmf94YoLktIMFq6r-bTKup_9Sm_7Ls2d3i34puGo79BkBWKaI</recordid><startdate>20220426</startdate><enddate>20220426</enddate><creator>Spangmose, Anne Lærke</creator><creator>Skipper, Niels</creator><creator>Knorr, Sine</creator><creator>Wullum Gundersen, Tina</creator><creator>Beck Jensen, Rikke</creator><creator>Damm, Peter</creator><creator>Lykke Mortensen, Erik</creator><creator>Pinborg, Anja</creator><creator>Svensson, Jannet</creator><creator>Clausen, Tine</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>IOV</scope><scope>ISN</scope><scope>ISR</scope><scope>3V.</scope><scope>7TK</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope><scope>CZK</scope><orcidid>https://orcid.org/0000-0002-2067-5246</orcidid><orcidid>https://orcid.org/0000-0002-8340-104X</orcidid><orcidid>https://orcid.org/0000-0001-7541-5858</orcidid><orcidid>https://orcid.org/0000-0001-6552-5340</orcidid><orcidid>https://orcid.org/0000-0002-4522-672X</orcidid><orcidid>https://orcid.org/0000-0002-9365-0728</orcidid><orcidid>https://orcid.org/0000-0002-6985-451X</orcidid></search><sort><creationdate>20220426</creationdate><title>School performance in Danish children exposed to maternal type 1 diabetes in utero: A nationwide retrospective cohort study</title><author>Spangmose, Anne Lærke ; Skipper, Niels ; Knorr, Sine ; Wullum Gundersen, Tina ; Beck Jensen, Rikke ; Damm, Peter ; Lykke Mortensen, Erik ; Pinborg, Anja ; Svensson, Jannet ; Clausen, Tine</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c694t-4359ad584f0a3ac1bc5d817065c46cc954e22dee772ca2b296171ce6380302ce3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Academic achievement</topic><topic>Academic Performance</topic><topic>Achievement tests</topic><topic>Birth weight</topic><topic>Child</topic><topic>Children</topic><topic>Cognitive ability</topic><topic>Cohort analysis</topic><topic>Cohort Studies</topic><topic>Complications and side effects</topic><topic>Demographic aspects</topic><topic>Denmark - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><collection>PLoS Medicine</collection><jtitle>PLoS medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Spangmose, Anne Lærke</au><au>Skipper, Niels</au><au>Knorr, Sine</au><au>Wullum Gundersen, Tina</au><au>Beck Jensen, Rikke</au><au>Damm, Peter</au><au>Lykke Mortensen, Erik</au><au>Pinborg, Anja</au><au>Svensson, Jannet</au><au>Clausen, Tine</au><au>Persson, Lars Åke</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>School performance in Danish children exposed to maternal type 1 diabetes in utero: A nationwide retrospective cohort study</atitle><jtitle>PLoS medicine</jtitle><addtitle>PLoS Med</addtitle><date>2022-04-26</date><risdate>2022</risdate><volume>19</volume><issue>4</issue><spage>e1003977</spage><epage>e1003977</epage><pages>e1003977-e1003977</pages><issn>1549-1676</issn><issn>1549-1277</issn><eissn>1549-1676</eissn><abstract>Conflicting results have been reported concerning possible adverse effects on the cognitive function of offspring of mothers with type 1 diabetes (O-mT1D). Previous studies have included offspring of parents from the background population (O-BP), but not offspring of fathers with type 1 diabetes (O-fT1D) as the unexposed reference group.
This is a population-based retrospective cohort study from 2010 to 2016. Nationally standardized school test scores (range, 1 to 100) were obtained for public school grades 2, 3, 4, 6, and 8 in O-mT1D and compared with those in O-fT1D and O-BP. Of the 622,073 included children, 2,144 were O-mT1D, and 3,474 were O-fT1D. Multiple linear regression models were used to compare outcomes, including the covariates offspring with type 1 diabetes, parity, number of siblings, offspring sex, smoking during pregnancy, parental age, and socioeconomic factors. Mean test scores were 54.2 (standard deviation, SD 24.8) in O-mT1D, 54.4 (SD 24.8) in O-fT1D, and 56.4 (SD 24.7) in O-BP. In adjusted analyses, the mean differences in test scores were -1.59 (95% CI -2.48 to -0.71, p < 0.001) between O-mT1D and O-BP and -0.78 (95% CI -1.48 to -0.08, p = 0.03) between O-fT1D and O-BP. No significant difference in the adjusted mean test scores was found between O-mT1D and O-fT1D (p = 0.16). The study's limitation was no access to measures of glycemic control during pregnancy.
O-mT1D achieved lower test scores than O-BP but similar test scores compared with O-fT1D. Glycemic control during pregnancy is essential to prevent various adverse pregnancy outcomes in women with type 1 diabetes. However, the present study reduces previous concerns regarding adverse effects of in utero hyperglycemia on offspring cognitive function.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>35472047</pmid><doi>10.1371/journal.pmed.1003977</doi><orcidid>https://orcid.org/0000-0002-2067-5246</orcidid><orcidid>https://orcid.org/0000-0002-8340-104X</orcidid><orcidid>https://orcid.org/0000-0001-7541-5858</orcidid><orcidid>https://orcid.org/0000-0001-6552-5340</orcidid><orcidid>https://orcid.org/0000-0002-4522-672X</orcidid><orcidid>https://orcid.org/0000-0002-9365-0728</orcidid><orcidid>https://orcid.org/0000-0002-6985-451X</orcidid><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Public Library of Science (PLoS); PubMed Central |
| subjects | Academic achievement Academic Performance Achievement tests Birth weight Child Children Cognitive ability Cohort analysis Cohort Studies Complications and side effects Demographic aspects Denmark - epidemiology Diabetes Diabetes mellitus (insulin dependent) Diabetes Mellitus, Type 1 - epidemiology Elementary school students Father and child Female Genetic aspects Gestational age Health aspects Humans Hyperglycemia Insulin Medicine and Health Sciences Mother and child Obstetrics Offspring People and places Population studies Pregnancy Prenatal Exposure Delayed Effects - epidemiology Private schools Public schools Reading Regression analysis Retrospective Studies Side effects Social Sciences Socioeconomic factors Type 2 diabetes |
| title | School performance in Danish children exposed to maternal type 1 diabetes in utero: A nationwide retrospective cohort study |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-24T01%3A27%3A01IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=School%20performance%20in%20Danish%20children%20exposed%20to%20maternal%20type%201%20diabetes%20in%20utero:%20A%20nationwide%20retrospective%20cohort%20study&rft.jtitle=PLoS%20medicine&rft.au=Spangmose,%20Anne%20L%C3%A6rke&rft.date=2022-04-26&rft.volume=19&rft.issue=4&rft.spage=e1003977&rft.epage=e1003977&rft.pages=e1003977-e1003977&rft.issn=1549-1676&rft.eissn=1549-1676&rft_id=info:doi/10.1371/journal.pmed.1003977&rft_dat=%3Cgale_plos_%3EA702592178%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2665134600&rft_id=info:pmid/35472047&rft_galeid=A702592178&rft_doaj_id=oai_doaj_org_article_4982df66671a410c8292293b9db92ed4&rfr_iscdi=true |