Pregestational diabetes mellitus (PGDM; including type 1 diabetes mellitus [T1DM] and type 2 diabetes mellitus [T2DM]) and gestational diabetes mellitus (GDM) are common metabolic diseases during pregnancy. It was estimated that approximately 2.2% of all births in the USA were to females with PGDM. 1 The prevalence of GDM varies substantially worldwide and occurs in approximately 1% to more than 30% of pregnancies depending on age, geography, ethnicity, lifestyle, and genetic factors. 2 Many epidemiological studies suggest an increased risk of neurodevelopmental disorders (NDDs) in offspring born to mothers with PGDM or GDM, such as autism spectrum disorder (ASD), 3-5 attention-deficit/hyperactivity disorder (ADHD), 5,6 developmental delay, 7 intellectual disability, 5 cerebral palsy (CP), 8 and epilepsy/infantile spasms. 9 Thereby, maternal hyperglycaemia, hyperinsulinaemia, inflammation, epigenetic factors, autoimmune dysfunction, placental malperfusion, or oxidative stress in utero are considered to be the potential causes of childhood NDDs. [10][11][12] Although several studies have reported the association of maternal PGDM or GDM with childhood NDDs, most of them focused only on specific types of NDD (e.g. ASD or ADHD) and many of them did not report the effect of T1DM, T2DM, and GDM on NDDs at the same time. It would be very interesting to comprehensively assess the impact of PGDM and GDM on a wide range of NDDs using data collected in the same cohort; we could then directly compare the associations of T1DM, T2DM, and GDM on childhood NDDs. For instance, although one case-control study suggested that maternal diabetes increases the risk of neonatal seizures in term-born infants, 9 whether T1DM, T2DM, and GDM have the same influence remains unanswered and deserves further investigation.
