The Association between Gestational Diabetes Mellitus (GDM) in Mothers and Attention Deficit/Hyperactivity Disorder (ADHD) in Their Offspring

  • Pathamabhorn Thongsookdee Department of Psychiatry, Faculty of Medicine, Chiang Mai University
  • Chawanun Charnsil Department of Psychiatry, Faculty of Medicine, Chiang Mai University
  • Manit Srisurapanont Department of Psychiatry, Faculty of Medicine, Chiang Mai University
Keywords: gestational diabetes mellitus; attention deficit;hyperactivity disorder; offspring


Objective : To examines the association between gestational diabetes mellitus (GDM)
in Thai mothers and attention deficit/hyperactivity disorder (ADHD) in their offspring.
Method : The case-control study was conducted. We enrolled 132 mother-child pairs,
consisting of 66 mothers with ADHD in their offspring (ADHD group) and 66 mothers
without ADHD in their offspring (non ADHD group). Demographic data and obstetric
and neonatal history affecting ADHD in offspring were obtained from mothers and corresponding
children seeking treatment from the Child and Adolescent Psychiatric Unit
and General Child Disease Unit of Maharaj Nakorn Chiang Mai Hospital. Maternal GDM
history was obtained by an interview. The ADHD in the offspring was diagnosed by
certified Thai child and adolescent psychiatrists.
Results : We found the ratio of male vs. female children in the ADHD and the non ADHD
group to be 2.882:1 and 2:1 respectively (P = 0.446). Demographic and obstetric
characteristics were not significantly different between the groups. Maternal GDM was
found in seven mothers in the ADHD group (10.61%) and two mothers in the non ADHD
group (3.03%). In comparison with mothers without GDM, mothers with GDM had an
increased risk of having offspring with ADHD, but without statistical significance
(OR = 3.797, 95% CI = 0.752-19.009, P = 0.105).
Conclusion : GDM is not the factor that increased the risk of ADHD diagnosis in children.
However, it performs the trend of association that GDM might increase the risk of ADHD.


Download data is not yet available.


Faraone SV. Report from the 4th international meeting of the attention deficit hyperactivity disorder molecular genetics network. Am J Med Genet B Neuropsychiatr Genet 2003; 121B: 55-9.

Larson K, Russ SA, Kahn RS, Halfon N. Patterns of comorbidity, functioning, and service use for US children with ADHD, 2007. Pediatrics 2011; 127: 462-70.

Pastor PN, Reuben CA. Diagnosed attention deficit hyperactivity disorder and learning disability: United States, 2004-2006. Vital Health Stat 10 2008; 237: 1-14.

Strine TW, Lesesne CA, Okoro CA, McGuire LC, Chapman DP, Balluz LS, et al. Emotional and behavioral difficulties and impairments in everyday functioning among children with a history of attention-deficit/hyperactivity disorder. Prev Chronic Dis 2006; 3: 1-10.

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th edition. Arlington: American Psychiatric Publishing; 2013.

Polanczyk G, Lima MS, Horta BL, Biederman J, Rohde LA. The worldwide prevalence of ADHD: a systematic review and metaregression analysis. Am J Psychiatry 2007; 164: 942-48.

Benjasuwantep B, Ruangdaraganon N, Visudhiphan P. Prevalence and clinical characteristics of attention deficit hyperactivity disorder among primary school students in Bangkok. J Med Assoc Thai 2002; 85 (Suppl 4): 1232-40.

Division of Medical Record Siriraj Hospital & Mahidol University. Statistical report 2014: Siriraj Hospital. Bangkok: Division of Medical Record Siriraj Hospital. Bangkok, 2014.

Curran EA, Cryan JF, Kenny LC, Dinan TG, Kearney PM, Khashan AS. Obstetrical Mode of Delivery and Childhood Behavior and Psychological Development in a British Cohort. J Autism Dev Disord 2016; 46: 603-14.

Curran EA, Khashan AS, Dalman C, Kenny LC, Cryan JF, Dinan TG, et al. Obstetric mode of delivery and attention-deficit/hyperactivity disorder: a sibling-matched study. Int J Epidemiol 2016; 45: 532-42.

Curran EA, O’Neill SM, Cryan JF, Kenny LC, Dinan TG, Khashan AS, et al. Research review: Birth by caesarean section and development of autism spectrum disorder and attention-deficit/hyperactivity disorder: a systematic review and meta-analysis. J Child Psychol Psychiatry 2015; 56: 500-08.

Instanes JT, Halmoy A, Engeland A, Haavik J, Furu K, Klungsoyr K. Attention-Deficit/ Hyperactivity Disorder in Offspring of Mothers with Inflammatory and Immune System Diseases. Biol Psychiatry 2015; 81: 452-59.

Jerome L, Segal A, Habinski L. What we know about ADHD and driving risk: a literature review, meta-analysis and critique. J Can Acad Child Adolesc Psychiatry 2006; 15: 105-25.

Martin A, Volkmar F, editors. Lewis’s Child and Adolescent Psychiatry: A Comprehensive Textbook. 4th edition. Philadelphia:LWW; 2007

Serati M, Barkin JL, Orsenigo G, Altamura AC, Buoli M. Research Review: The role of obstetric and neonatal complications in childhood attention deficit and hyperactivity disorder - a systematic review. J Child Psychol Psychiatry 2017; 58: 1290-300.

Talge NM, Allswede DM, Holzman C. Gestational Age at Term, Delivery Circumstance, and Their Association with Childhood Attention Deficit Hyperactivity Disorder Symptoms. Paediatr Perinat Epidemiol 2016; 30: 171-80.

Luewan S. Diabetes Mellitus in Pregnancy. 2015 [cited Feb 23,2015]. Available from index.php?option=com_content&view=article &id=1094:2015-02-23-01-52-19&catid=38& Itemid=480

Zhu Y, Zhang C. Prevalence of Gestational Diabetes and Risk of Progression to Type 2 Diabetes: a Global Perspective. Current Diab reportsRep 2016; 16: 7.

Cai S, Qiu A, Broekman BF, Wong EQ, Gluckman PD, Godfrey KM, et al.The Influence of Gestational Diabetes on Neurodevelopment of Children in the First Two Years of Life: A Prospective Study. PLoS One 2016; 11: e0162113.

Kaaja R, Rönnemaa T. Gestational diabetes: pathogenesis and consequences to mother and offspring. Rev Diabet Stud 2008; 5: 194- 202.

van der Burg JW, Sen S, Chomitz VR, Seidell JC, Leviton A, Dammann O. (2016). The role of systemic inflammation linking maternal BMI to neurodevelopment in children. Pediatr Res 2016; 79: 3-12.

Banik A, Kandilya D, Ramya S, Stunkel W, Chong YS, Dheen ST. Maternal Factors that Induce Epigenetic Changes Contribute to Neurological Disorders in Offspring. Genes (Basel) 2017; 8: 1-25.

Zucker I. Risk Mitigation for Children Exposed to Drugs During Gestation: A Critical Role for Animal Preclinical Behavioral Testing. Neurosci Biobehav Rev 2017; 77: 107-21.

Ornoy A, Ratzon N, Greenbaum C, Wolf A, Dulitzky M. School-age children born to diabetic mothers and to mothers with gestational diabetes exhibit a high rate of inattention and fine and gross motor impairment. J Pediatr Endocrinol Metab. 2001;14 (Suppl 1): s681-s89.

Ornoy A, Wolf A, Ratzon N, Greenbaum C, Dulitzky M. Neurodevelopmental outcome at early school age of children born to mothers with gestational diabetes. Arch Dis Child Fetal Neonatal Ed 1999; 81: F10-4.

Daraki V, Roumeliotaki T, Koutra K, Georgiou V, Kampouri M, Kyriklaki A, et al. Effect of parental obesity and gestational diabetes on child neuropsychological and behavioral development at 4 years of age: the Rhea mother-child cohort, Crete, Greece. Eur Child Adolesc Psychiatry 2017; 26: 703-14.

Pityaratstian N, Booranasuksakul T, Juengsiragulwit D, Benyakorn S. ADHD Screening Properties of the Thai Version of Swanson, Nolan, and Pelham IV Scale (SNAP-IV) and Strengths and Difficulties Questionnaire (SDQ). Journal of the Psychiatric Association of Thailand 2014; 59: 97-110.

Schmitt J, Romanos M. Prenatal and perinatal risk factors for attention-deficit/hyperactivity disorder. Arch Pediatr Adolesc Med 2012; 166: 1074-75.

Nomura Y, Marks DJ, Grossman B, Yoon M, Loudon H, Stone J, et al. Exposure to gestational diabetes mellitus and low socio¬economic status: effects on neurocognitive development and risk of attention-deficit/hy¬peractivity disorder in offspring. Arch Pediatr Adolesc Med 2012; 166: 337-43.

Thapar A, Pine D, Leckman JF, Scott S, Snowling M, Taylor E, editors. Rutter’s Child and Adolescent Psychiatry. 6th edition. New York: John Wiley & Sons Inc.; 2017.

Luewan S, Bootchaingam P, Tongsong T. Comparison of the Screening Tests for Gestational Diabetes Mellitus between “One-Step” and “Two-Step” Methods among Thai Pregnant Women. Obstet Gynecol Int 2018; 2018: 1521794.

How to Cite
Thongsookdee, P., Charnsil, C., & Srisurapanont, M. (2020). The Association between Gestational Diabetes Mellitus (GDM) in Mothers and Attention Deficit/Hyperactivity Disorder (ADHD) in Their Offspring. Journal of the Psychiatric Association of Thailand, 65(2), 141-152. Retrieved from