Dietary glycemic index and load during pregnancy and offspring behavioral outcomes: exploring sex differences

Abstract

Behavioral problems; Child; Child development; Pregnancy nutrition

Problemes de comportament; Desenvolupament infantil; Nutrició durant l’embaràs

Problemas de comportamiento; Desarrollo infantil; Nutrición durante el embarazo

Given the importance of carbohydrates during pregnancy and the limited evidence on the impact of its excessive intake on offspring neurodevelopment, this study aimed to assess the associations between maternal glycemic index (GI) and glycemic load (GL) during early and late pregnancy and behavior problems in 4-year-old children, considering potential sex-related differences in susceptibility to maternal diet. This observational study included 188 mother-child pairs from the ECLIPSES study. GI and GL were estimated from a validated food frequency questionnaire. Offspring behavior was assessed using the Child Behavior Checklist 1.5-5. Multivariable linear and logistic regression analyses were employed to assess the association between GI, GL, and child behavior. Children of mothers in the highest tertile of GL during the first trimester of pregnancy showed elevated scores of both internalizing (β = 5.77; 95% CI, 2.28-9.26) and externalizing (β = 3.95; 95% CI, 0.70-7.19) problems, including anxiety and depression problems, withdrawn, attention problems, aggressive behavior, and attention-deficit/hyperactivity problems, as well as total (β = 5.24; 95% CI, 1.71-8.77) and autism spectrum problems (β = 3.30; 95% CI, 1.11-5.50). Similarly, higher odd ratios were observed for internalizing (OR = 2.37; 95% CI, 1.09-5.18), externalizing (OR = 3.46; 95% CI, 1.49-8.00), and total problems (OR = 3.83; 95% CI, 1.68-8.71). These associations were more pronounced in girls. No associations were observed during the third trimester. Regarding GI, no associations were found for the evaluated outcomes in any of the trimesters.

These findings indicated that elevated maternal GL during the early pregnancy, but not later stages, was associated with adverse behavioral outcomes in offspring.

EUCTR-2012-005480-28, NCT03196882.

• Carbohydrate intake is important during pregnancy as glucose is the main energy source for an optimal fetal brain development. • Elevated prenatal glycemic index and glycemic load have been associated with adverse offspring outcomes but their impact on behavioral development remains insufficiently explored.

• A high maternal glycemic load during pregnancy may increase the risk of behavioral impairments in preschool-aged offspring. • Female offspring may be more vulnerable to behavioral disturbances to elevated maternal glycemic load during gestation.

Open Access funding provided thanks to the CRUE-CSIC agreement with Springer Nature. The ECLIPSES study was fnancially supported by the Health Research Fund of the Ministry of Health and Consumption (Madrid, Spain) (Instituto de Salud Carlos III, Fondo de Investigación Sanitaria, Ministerio de Sanidad y Consumo) with grants numbers PI12/02777 and PI17/01754 and co-funded by European Union (ERDF/ESF, “A way to make Europe”/ “Investing in your future”). Esther Cendra-Duarte is a researcher engaged in the Investigo 2023 Program, within the framework of the Recovery, Transformation, and Resilience Plan funded by the European Union through NextGenerationEU. Nerea Becerra-Tomás was supported by the Beatriz Galindo program from the Spanish Ministry of Universities (BG22/00050). Javier Mateu-Fabregat received a pre-doctoral fellowship from the Generalitat de Catalunya’s Agència de Gestió d’Ajuts Universitaris i de Recerca (AGAUR), Barcelona, Spain (grant number 2023 FISDU 00387). Mònica Bulló received the ICREA Academy 2023 Distinction from the Autonomous Government of Catalunya.