Long-term follow-up of children with in utero exposure to sulfonylurea medications

Marissa S. Rodenstein; Monica E. Bianco; Maegan U. Ramchal; Michael Murias; Rebecca L. Silton; Jami L. Josefson

doi:10.1002/osp4.488

Long-term follow-up of children with in utero exposure to sulfonylurea medications

Marissa S. Rodenstein, Monica E. Bianco, Maegan U. Ramchal, Michael Murias, Rebecca L. Silton, Jami L. Josefson^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

2 Scopus citations

Abstract

Background: Offspring born to mothers with gestational diabetes mellitus (GDM) are more likely to have negative neurodevelopmental health outcomes, early obesity, type 2 diabetes, and metabolic syndrome in childhood, adolescence, and adulthood. Standard of care management for GDM and type 2 diabetes mellitus during pregnancy is insulin, but oral sulfonylurea use is increasing, and these medications cross the placenta. Literature on treatment with sulfonylureas for maternal GDM has focused on maternal glycemic control and neonatal outcomes. Studies that have evaluated the long-term outcomes of children exposed to sulfonylureas in utero are limited. Objective: This study evaluated anthropometric and neurodevelopmental outcomes of 55 children (ages 5–10) born to mothers with diabetes during pregnancy treated with sulfonylurea or insulin. Methods and Results: A group of 25 sulfonylurea-exposed and 30 insulin-exposed participants were age- and sex-matched between groups. No significant differences were identified in z-scores for body mass index (BMI), waist circumference, skinfold measurements, and body fat or rates of overweight/obese BMI between groups. On performance-based cognitive assessment, the sulfonylurea-exposed group had significantly lower scores on inhibition (p = 0.043). Conclusion: In summary, children with in utero sulfonylurea exposure had similar physical measurements compared to children with insulin exposure and lower performance on a measure of executive function (inhibition), which is associated with adverse health outcomes.

Original language	English (US)
Pages (from-to)	487-493
Number of pages	7
Journal	Obesity Science and Practice
Volume	7
Issue number	4
DOIs	https://doi.org/10.1002/osp4.488
State	Published - Aug 2021

Funding

The authors thank all of the children and mothers who participated in this study, as well as Aneta Jedraszko for coordinating study visits. Many thanks to the Clinical Research Unit at Lurie Children's Hospital of Chicago and the Institute for Innovations in Developmental Sciences at Northwestern University. This research was supported in part by the Northwestern Medicine Enterprise Data Warehouse. Funding for this study was provided by Northwestern DevSci Institute for Pilot Research Initiatives and the Northwestern Evergreen Invitational of the Women's Board of Northwestern Memorial Hospital. Funding sources were not involved in the collection, analysis, or interpretation of any data, in the writing of the report, or in the decision to submit the article for publication.

Keywords

child body composition
child neurodevelopmental outcomes
gestational diabetes mellitus
sulfonylurea exposure

ASJC Scopus subject areas

Nutrition and Dietetics
Endocrinology, Diabetes and Metabolism

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1002/osp4.488

Cite this

@article{f1fd3338fe9b4c2fabab443e2a96cb06,

title = "Long-term follow-up of children with in utero exposure to sulfonylurea medications",

abstract = "Background: Offspring born to mothers with gestational diabetes mellitus (GDM) are more likely to have negative neurodevelopmental health outcomes, early obesity, type 2 diabetes, and metabolic syndrome in childhood, adolescence, and adulthood. Standard of care management for GDM and type 2 diabetes mellitus during pregnancy is insulin, but oral sulfonylurea use is increasing, and these medications cross the placenta. Literature on treatment with sulfonylureas for maternal GDM has focused on maternal glycemic control and neonatal outcomes. Studies that have evaluated the long-term outcomes of children exposed to sulfonylureas in utero are limited. Objective: This study evaluated anthropometric and neurodevelopmental outcomes of 55 children (ages 5–10) born to mothers with diabetes during pregnancy treated with sulfonylurea or insulin. Methods and Results: A group of 25 sulfonylurea-exposed and 30 insulin-exposed participants were age- and sex-matched between groups. No significant differences were identified in z-scores for body mass index (BMI), waist circumference, skinfold measurements, and body fat or rates of overweight/obese BMI between groups. On performance-based cognitive assessment, the sulfonylurea-exposed group had significantly lower scores on inhibition (p = 0.043). Conclusion: In summary, children with in utero sulfonylurea exposure had similar physical measurements compared to children with insulin exposure and lower performance on a measure of executive function (inhibition), which is associated with adverse health outcomes.",

keywords = "child body composition, child neurodevelopmental outcomes, gestational diabetes mellitus, sulfonylurea exposure",

author = "Rodenstein, {Marissa S.} and Bianco, {Monica E.} and Ramchal, {Maegan U.} and Michael Murias and Silton, {Rebecca L.} and Josefson, {Jami L.}",

note = "Funding Information: The authors thank all of the children and mothers who participated in this study, as well as Aneta Jedraszko for coordinating study visits. Many thanks to the Clinical Research Unit at Lurie Children's Hospital of Chicago and the Institute for Innovations in Developmental Sciences at Northwestern University. This research was supported in part by the Northwestern Medicine Enterprise Data Warehouse. Funding for this study was provided by Northwestern DevSci Institute for Pilot Research Initiatives and the Northwestern Evergreen Invitational of the Women's Board of Northwestern Memorial Hospital. Funding sources were not involved in the collection, analysis, or interpretation of any data, in the writing of the report, or in the decision to submit the article for publication. Publisher Copyright: {\textcopyright} 2021 The Authors. Obesity Science & Practice published by World Obesity and The Obesity Society and John Wiley & Sons Ltd.",

year = "2021",

month = aug,

doi = "10.1002/osp4.488",

language = "English (US)",

volume = "7",

pages = "487--493",

journal = "Obesity Science and Practice",

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T1 - Long-term follow-up of children with in utero exposure to sulfonylurea medications

AU - Rodenstein, Marissa S.

AU - Bianco, Monica E.

AU - Ramchal, Maegan U.

AU - Murias, Michael

AU - Silton, Rebecca L.

AU - Josefson, Jami L.

N1 - Funding Information: The authors thank all of the children and mothers who participated in this study, as well as Aneta Jedraszko for coordinating study visits. Many thanks to the Clinical Research Unit at Lurie Children's Hospital of Chicago and the Institute for Innovations in Developmental Sciences at Northwestern University. This research was supported in part by the Northwestern Medicine Enterprise Data Warehouse. Funding for this study was provided by Northwestern DevSci Institute for Pilot Research Initiatives and the Northwestern Evergreen Invitational of the Women's Board of Northwestern Memorial Hospital. Funding sources were not involved in the collection, analysis, or interpretation of any data, in the writing of the report, or in the decision to submit the article for publication. Publisher Copyright: © 2021 The Authors. Obesity Science & Practice published by World Obesity and The Obesity Society and John Wiley & Sons Ltd.

PY - 2021/8

Y1 - 2021/8

N2 - Background: Offspring born to mothers with gestational diabetes mellitus (GDM) are more likely to have negative neurodevelopmental health outcomes, early obesity, type 2 diabetes, and metabolic syndrome in childhood, adolescence, and adulthood. Standard of care management for GDM and type 2 diabetes mellitus during pregnancy is insulin, but oral sulfonylurea use is increasing, and these medications cross the placenta. Literature on treatment with sulfonylureas for maternal GDM has focused on maternal glycemic control and neonatal outcomes. Studies that have evaluated the long-term outcomes of children exposed to sulfonylureas in utero are limited. Objective: This study evaluated anthropometric and neurodevelopmental outcomes of 55 children (ages 5–10) born to mothers with diabetes during pregnancy treated with sulfonylurea or insulin. Methods and Results: A group of 25 sulfonylurea-exposed and 30 insulin-exposed participants were age- and sex-matched between groups. No significant differences were identified in z-scores for body mass index (BMI), waist circumference, skinfold measurements, and body fat or rates of overweight/obese BMI between groups. On performance-based cognitive assessment, the sulfonylurea-exposed group had significantly lower scores on inhibition (p = 0.043). Conclusion: In summary, children with in utero sulfonylurea exposure had similar physical measurements compared to children with insulin exposure and lower performance on a measure of executive function (inhibition), which is associated with adverse health outcomes.

AB - Background: Offspring born to mothers with gestational diabetes mellitus (GDM) are more likely to have negative neurodevelopmental health outcomes, early obesity, type 2 diabetes, and metabolic syndrome in childhood, adolescence, and adulthood. Standard of care management for GDM and type 2 diabetes mellitus during pregnancy is insulin, but oral sulfonylurea use is increasing, and these medications cross the placenta. Literature on treatment with sulfonylureas for maternal GDM has focused on maternal glycemic control and neonatal outcomes. Studies that have evaluated the long-term outcomes of children exposed to sulfonylureas in utero are limited. Objective: This study evaluated anthropometric and neurodevelopmental outcomes of 55 children (ages 5–10) born to mothers with diabetes during pregnancy treated with sulfonylurea or insulin. Methods and Results: A group of 25 sulfonylurea-exposed and 30 insulin-exposed participants were age- and sex-matched between groups. No significant differences were identified in z-scores for body mass index (BMI), waist circumference, skinfold measurements, and body fat or rates of overweight/obese BMI between groups. On performance-based cognitive assessment, the sulfonylurea-exposed group had significantly lower scores on inhibition (p = 0.043). Conclusion: In summary, children with in utero sulfonylurea exposure had similar physical measurements compared to children with insulin exposure and lower performance on a measure of executive function (inhibition), which is associated with adverse health outcomes.

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KW - child neurodevelopmental outcomes

KW - gestational diabetes mellitus

KW - sulfonylurea exposure

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