{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T05:07:49Z","timestamp":1784092069481,"version":"3.55.0"},"reference-count":34,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T00:00:00Z","timestamp":1784073600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Clin. Diabetes Healthc."],"abstract":"<jats:p>\n                    Maternal diabetes, encompassing gestational diabetes mellitus and pre-existing type 1 and type 2 diabetes are associated with adverse perinatal outcomes. Emerging evidence suggests that maternal hyperglycemia and insulin resistance may be associated with long-term neurodevelopmental outcomes, particularly increasing the risk of autism spectrum disorder (ASD) and attention-deficit\/hyperactivity disorder (ADHD). This review synthesizes current epidemiological and mechanistic evidence linking maternal diabetes with the incidence of ASD and ADHD in offspring. Large population-based cohort studies consistently demonstrate an elevated risk of ASD and ADHD among children exposed to maternal diabetes\n                    <jats:italic>in utero<\/jats:italic>\n                    , with risk magnitude varying according to diabetes type, timing of diagnosis, and treatment modality. ADHD appears to show a stronger and more consistent association, particularly in offspring of mothers with type 1 diabetes. Proposed biological mechanisms include hyperglycemia-induced oxidative stress, epigenetic modifications, hormonal dysregulation involving estrogen, progesterone, and androgens, and an increased incidence of preterm birth. Maternal factors such as obesity, advanced age, and fertility treatments further modulate risk. Despite accumulating evidence, heterogeneity across studies and residual confounding limit causal inference. Future prospective studies integrating detailed glycemic profiling, hormonal assessments, and neurodevelopmental phenotyping are required to elucidate underlying mechanisms and inform preventive strategies for pregnancies complicated by diabetes.\n                  <\/jats:p>","DOI":"10.3389\/fcdhc.2026.1855251","type":"journal-article","created":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T04:44:24Z","timestamp":1784090664000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Is maternal diabetes associated with autism spectrum disorder and ADHD in the offspring? A short review"],"prefix":"10.3389","volume":"7","author":[{"given":"Salam","family":"Alshammaa","sequence":"first","affiliation":[{"name":"Basic Medical Science Department, College of Medicine, University of Sharjah","place":["Sharjah, United Arab Emirates"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bashair M.","family":"Mussa","sequence":"additional","affiliation":[{"name":"Basic Medical Science Department, College of Medicine, University of Sharjah","place":["Sharjah, United Arab Emirates"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amena","family":"Sadiya","sequence":"additional","affiliation":[{"name":"Clinical Science Department, College of Medicine, University of Sharjah","place":["Sharjah, United Arab Emirates"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salah","family":"Abusnana","sequence":"additional","affiliation":[{"name":"Clinical Science Department, College of Medicine, University of Sharjah","place":["Sharjah, United Arab Emirates"]},{"name":"Diabetes and Endocrinology Department, University Hospital Sharjah","place":["Sharjah, United Arab Emirates"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,15]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"199","DOI":"10.3109\/14767050903550659","article-title":"The fetal and maternal consequences of gestational diabetes mellitus","volume":"23","author":"Reece","year":"2010","journal-title":"J Maternal-Fetal Neonatal Med"},{"key":"B2","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1192\/bjp.bp.108.051672","article-title":"Prenatal risk factors for autism: comprehensive meta-analysis","volume":"195","author":"Gardener","year":"2009","journal-title":"Br J Psychiatry"},{"key":"B3","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1038\/s41598-021-84573-3","article-title":"The association between gestational diabetes and ASD and ADHD: a systematic review and meta-analysis","volume":"11","author":"Rowland","year":"2021","journal-title":"Sci Rep"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)31129-2","article-title":"Autism spectrum disorder","volume":"392","author":"Lord","year":"2018","journal-title":"Lancet"},{"key":"B5","doi-asserted-by":"publisher","first-page":"994","DOI":"10.1177\/08830738050200121301","article-title":"What is attention-deficit hyperactivity disorder (ADHD)","volume":"20","author":"Furman","year":"2005","journal-title":"J Child Neurol"},{"key":"B6","doi-asserted-by":"publisher","first-page":"1","DOI":"10.15585\/mmwr.ss7402a1","article-title":"Prevalence and characteristics of Autism Spectrum Disorder among children aged 8 Years \u2014 autism and developmental disabilities monitoring network, 16 Sites, United States, 2022","volume":"74","author":"Maenner","year":"2025","journal-title":"MMWR Surveillance Summaries"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2015.2707","article-title":"Association of maternal diabetes with autism in offspring","volume":"313","author":"Xiang","year":"2015","journal-title":"JAMA"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.5603\/dk.2016.0026","article-title":"The association of maternal gestational diabetes mellitus with autism spectrum disorders in the offspring","volume":"5","author":"Kania","year":"2016","journal-title":"Clin Diabetol"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000011080","article-title":"Association of maternal diabetes with autism spectrum disorders in offspring: a systemic review and meta-analysis","volume":"97","author":"Wan","year":"2018","journal-title":"Medicine"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyac116","article-title":"Maternal type 1 diabetes, pre-term birth and risk of autism spectrum disorder\u2013a prospective cohort study","volume":"52","author":"Persson","year":"2022","journal-title":"Int J Epidemiol"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1001\/archpediatrics.2011.784","article-title":"Exposure to gestational diabetes mellitus and low socioeconomic status: effects on neurocognitive development and risk of attention-deficit\/hyperactivity disorder in offspring","volume":"166","author":"Nomura","year":"2012","journal-title":"Arch Pediatr Adolesc Med"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.2337\/dc18-0733","article-title":"Maternal gestational diabetes mellitus, type 1 diabetes, and type 2 diabetes during pregnancy and risk of ADHD in offspring","volume":"41","author":"Xiang","year":"2018","journal-title":"Diabetes Care"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2016.05.014","article-title":"Prenatal exposure to gestational diabetes mellitus as an independent risk factor for long-term neuropsychiatric morbidity of the offspring","volume":"215","author":"Sacks","year":"2016","journal-title":"Am J Obstetrics Gynecology"},{"key":"B14","doi-asserted-by":"publisher","first-page":"e1920787","DOI":"10.1001\/jamanetworkopen.2019.20787","article-title":"Associations of different types of maternal diabetes and body mass index with offspring psychiatric disorders","volume":"3","author":"Kong","year":"2020","journal-title":"JAMA Netw Open"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1084\/jem.20081188","article-title":"Transient high glucose causes persistent epigenetic changes and altered gene expression during subsequent normoglycemia","volume":"205","author":"El-Osta","year":"2008","journal-title":"J Exp Med"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1016\/j.expneurol.2007.06.029","article-title":"SOD2 protects neurons from injury in cell culture and animal models of diabetic neuropathy","volume":"208","author":"Vincent","year":"2007","journal-title":"Exp Neurol"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.1912625116","article-title":"Maternal diabetes induces autism-like behavior by hyperglycemia-mediated persistent oxidative stress and suppression of superoxide dismutase 2","volume":"116","author":"Wang","year":"2019","journal-title":"Proc Natl Acad Sci"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1016\/j.molmed.2006.07.004","article-title":"Estrogen receptors: new players in diabetes mellitus","volume":"12","author":"Barros","year":"2006","journal-title":"Trends Mol Med"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1210\/endocr\/bqaa030","article-title":"Unconventional estrogen signaling in health and disease","volume":"161","author":"Faltas","year":"2020","journal-title":"Endocrinology"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.3389\/fnmol.2021.717411","article-title":"Estrogen receptor \u03b2 as a candidate regulator of sex differences in the maternal immune activation model of ASD","volume":"14","author":"Arnold","year":"2021","journal-title":"Front Mol Neurosci"},{"key":"B21","doi-asserted-by":"publisher","first-page":"788","DOI":"10.1016\/j.neuron.2021.01.015","article-title":"Parallel in vivo analysis of large-effect autism genes implicates cortical neurogenesis and estrogen in risk and resilience","volume":"109","author":"Willsey","year":"2021","journal-title":"Neuron"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.3390\/ijms22010373","article-title":"The role of estrogen receptors and their signaling across psychiatric disorders","volume":"22","author":"Hwang","year":"2020","journal-title":"Int J Mol Sci"},{"key":"B23","article-title":"Evaluation of estrogen and G protein-coupled estrogen receptor 1 (GPER) levels in drug-na\u00efve patients with attention deficit hyperactivity disorder (ADHD)","volume":"18","author":"Sahin","year":"2018","journal-title":"Bosnian J Basic Med Sci"},{"key":"B24","doi-asserted-by":"publisher","first-page":"16316","DOI":"10.1038\/s41598-020-73330-7","article-title":"Progesterone increases blood glucose via hepatic progesterone receptor membrane component 1 under limited or impaired action of insulin","volume":"10","author":"Lee","year":"2020","journal-title":"Sci Rep"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.1016\/j.pnpbp.2018.05.003","article-title":"Infertility treatments during pregnancy and the risk of autism spectrum disorder in the offspring","volume":"86","author":"Davidovitch","year":"2018","journal-title":"Prog Neuro-Psychopharmacol Biol Psychiatry"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.33549\/physiolres.933907","article-title":"Differences in serum steroid hormones concentrations in spontaneously hypertensive rats (SHR)--an animal model of attention-deficit\/hyperactivity disorder (ADHD)","volume":"68","author":"Koz\u0142owska","year":"2019","journal-title":"Physiol Res"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.3390\/life11070644","article-title":"A Potential role and contribution of androgens in placental development and pregnancy","volume":"11","author":"Parsons","year":"2021","journal-title":"Life"},{"key":"B28","doi-asserted-by":"crossref","DOI":"10.1080\/09513590.2016.1248933","article-title":"Pregestational type 2 diabetes and gestational diabetes exhibit different sexual steroid profiles during pregnancy","volume":"33","author":"Villarroel","year":"2017","journal-title":"Gynecological Endocrinol"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.5455\/apd.72180","article-title":"Prenatal androgens and autistic, attention deficit hyperactivity disorder, and disruptive behavior disorders traits","volume":"21","author":"G\u00fcne\u015f","year":"2020","journal-title":"Anadolu Psikiyatri Dergisi-Anatolian J Psychiatry"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2022.3189","article-title":"Risk of adverse pregnancy outcomes among pregnant individuals with gestational diabetes by race and ethnicity in the United States, 2014-2020","volume":"327","author":"Venkatesh","year":"2022","journal-title":"JAMA"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-021-05482-8","article-title":"Potentially modifiable risk factors of preterm delivery in women with type 1 and type 2 diabetes","volume":"64","author":"S\u00f8holm","year":"2021","journal-title":"Diabetologia"},{"key":"B32","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s13229-019-0282-4","article-title":"Behavioral characteristics of autism spectrum disorder in very preterm birth children","volume":"10","author":"Chen","year":"2019","journal-title":"Mol Autism"},{"key":"B33","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0224343","article-title":"ADHD symptoms and their neurodevelopmental correlates in children born very preterm","volume":"15","author":"Montagna","year":"2020","journal-title":"PloS One"},{"key":"B34","doi-asserted-by":"publisher","first-page":"e2128005","DOI":"10.1001\/jamanetworkopen.2021.28005","article-title":"Associations of Maternal Diabetes during Pregnancy with Psychiatric Disorders in Offspring during the First 4 Decades of Life in a Population-Based Danish Birth Cohort","volume":"4","author":"e Silva","year":"2021","journal-title":"JAMA Netw Open"}],"container-title":["Frontiers in Clinical Diabetes and Healthcare"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcdhc.2026.1855251\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T04:44:30Z","timestamp":1784090670000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcdhc.2026.1855251\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,15]]},"references-count":34,"alternative-id":["10.3389\/fcdhc.2026.1855251"],"URL":"https:\/\/doi.org\/10.3389\/fcdhc.2026.1855251","relation":{},"ISSN":["2673-6616"],"issn-type":[{"value":"2673-6616","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,15]]},"article-number":"1855251"}}