Maternal Glycaemia and Child Educational Attainment at Age 5 in the Born in Bradford Cohort.

AIMS:There is emerging evidence that maternal hyperglycaemia may be associated with adverse offspring neuro-behavioural outcomes, which are foundational to educational success. We hypothesised that higher levels of maternal glucose would be associated with poorer educational attainment in early childhood. METHODS:The sample included 13,627 children from the UK's Born in Bradford cohort. Exposures included maternal fasting glucose, 2-h post-load glucose and a clinical diagnosis of gestational diabetes. The primary outcome was failure to achieve a 'good level of development' on the Early Years Foundation Stage Profile at age five. The association was tested using multivariable Poisson regression, accounting for sibling clusters and using multiple imputation for missing data. RESULTS:Higher maternal fasting glucose (at 26-28 weeks gestation) was associated with an increased risk of failing to achieve a good level of development (adjusted RR 1.04; 95% CI 1.00, 1.08; p = 0.034). This association appeared stronger in children of Pakistani ethnicity compared to White British ethnicity. No association was found for 2-h post-load glucose or gestational diabetes diagnosis. CONCLUSIONS:These findings offer insights into the developmental origins of inequalities in child educational outcomes and highlight potential opportunities to optimise future health and learning through interventions during pregnancy.