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Diabetes Care Publish Ahead of Print published online ahead of print August 13, 2007
DOI: 10.2337/dc07-1225
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Original Research

Cognitive function and army-rejection rate in young adult male offspring of women with diabetes: A Danish population-based cohort study

Gunnar Lauge Nielsen, MD1, Claus Dethlefsen, biostatistician2, Henrik Toft Sørensen, Dr. Med. Sci1, Jan Fog Pedersen, Dr. Med. Sci3 and Lars Molsted-Pedersen, Dr. Med. Sci4

1 Department of Clinical Epidemiology, Aarhus University Hospital, Forskningens Hus, 9000 Aalborg, Denmark
2 Center for Cardiovascular Research, Aalborg Hospital, Forskningens Hus, 9000 Aalborg, Denmark
3 Department of Radiology, Glostrup University Hospital, 2600 Glostrup, Denmark
4 Diabetes Centre, Department of Obstetrics, Rigshospitalet, Copenhagen University Hospital Copenhagen, Denmark

guln{at}rn.dk

ABSTRACT

Objective: While maternal diabetes is a known risk factor for perinatal complications, there is little data on long-term intellectual outcome in offspring. We compare the rejection rate and cognitive functioning of military conscripts according to maternal diabetic status during pregnancy.

Research Design and Methods: We identified a cohort of Danish male offspring of diabetic mothers born between 1976 and 1984 and followed this cohort together with population-based controls to military conscription. The main outcome was army-rejection rate and cognitive function measured with a validated intelligence test.

Results: The army rejection rate was 52.5% among 282 men, whose mothers had diabetes during pregnancy, and 45.4% among 870 controls [risk difference= 7.3 (95% CI: 0.6 to 14.0)]. Mean cognitive scores were 41.4 (95% CI: 40.2 to 42.6) units in diabetes mellitus (DM)-exposed conscripts and 42.7 (95% CI: 42.0 to 43.4) units among controls. Stratification by gestational age, Apgar score, and White class did not change the associations. In a subgroup analysis using available data on glycosylated hemoglobin (A1c) levels during pregnancy, this variable was inversely associated with cognitive functioning. In men with maternal A1c below 7% cognitive score was identical with controls.

Conclusions: The slightly higher army rejection rate in men with maternal diabetes indicates higher morbidity. The identical cognitive functioning in case of well controlled maternal diabetes compared with controls is reassuring, but the negative association between A1c and cognitive score highlights the importance of striving for optimal metabolic control in diabetic women who are or plan to become pregnant.


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