Impact on the newborn's nervous system

Abstract

Diabetes mellitus (DM) during pregnancy is a growing public health problem and is associated with multiple maternal-fetal and perinatal complications. In recent years, interest has expanded to include its potential long-term consequences for children's health, particularly neurodevelopment.

The available evidence shows an association between intrauterine exposure to maternal DM and various neurocognitive and behavioral alterations, including learning difficulties, lower intellectual and academic performance, attention deficit hyperactivity disorder (ADHD), and autism spectrum disorders. However, the magnitude and consistency of these associations vary depending on the type of diabetes, the degree of exposure to hyperglycemia, and the presence of other factors, such as maternal obesity, socioeconomic status, and genetic and environmental characteristics.

This dissertation will review the main epidemiological findings and proposed mechanisms, including fetal hypoxia, oxidative stress, inflammation, alterations in insulin signaling, and epigenetic modifications. Finally, prevention opportunities will be analyzed from the preconception period and throughout pregnancy, as well as the role of pediatric follow-up and the promotion of environments conducive to development. The objective is to integrate the available evidence and reflect on strategies that can transform a potential risk factor into a prevention opportunity.