The impact of maternal gestational diabetes on a child’s psychomotor development up to the age of 2 – from a delayed start to accelerated growth

Introduction
The psychomotor development of children born to mothers with gestational diabetes mellitus (GDM) has been extensively studied, yielding mixed results. This study aimed to statistically evaluate the impact of GDM on the psychomotor development of children up to two years of age in a local Polish population, using the global scale of early development (GSED) – a modern assessment tool recommended by the World Health Organization.

Material and methods
The analysis included 662 children (aged 1–24 months) with complete clinical data participating in the regional program entitled Coordinated and comprehensive family support in specialist counseling, prevention, diagnosis, and elimination of developmental irregularities in children up to 2 years of age in the Opole Voivodship, Poland. Psychomotor development was assessed using milestones from the GSED and summarized using the unidimensional developmental score (D-score). Developmental outcomes were expressed as D-scores and standardized developmental scores/development-for-age Z-scores (DAZ). Changes in DAZ over time by gestational age and presence of GDM were analyzed using multilevel modeling.

Results
Among preterm infants, those born to mothers with GDM initially showed delayed psychomotor development; however, they exhibited a significantly faster developmental trajectory (p < 0.05) compared to full-term children. The findings indicate a dynamic increase in DAZ among preterm infants exposed to GDM, suggesting a compensatory “catch-up” in development over time.

Conclusions
Offspring of mothers with GDM demonstrate an early developmental delay followed by a phase of accelerated growth, in contrast to the offspring of mothers without GDM, whose development follows a more stable trajectory. These findings underscore the importance of accounting for gestational age when evaluating the impact of GDM on child development.