EuHEA seminar: Paul Andrés Rodríguez Lesmes (Universitad del Rosario)

Paul Andrés Rodríguez Lesmes

Abstract

For years, diagnosis and treatment for gestational diabetes mellitus (GDM) has been an unresolved question. Current guidelines have established diagnosis and treatment standards, but the question remains on the potential impacts on child development via in-utero exposure to diabetes medications. We use uniquely rich data from the Born-in-Bradford cohort study, in which all pregnant women underwent universal screening for GDM based on clear thresholds over oral glucose tolerance tests (OGTT), rather than using pre-existing conditions as a screening criterion (as it is the standard practice in England and elsewhere). To evaluate the effects of GDM treatment, we use the OGTT cutoff within a sharp regression discontinuity design, so we compare children from pregnancies with a positive and negative GDM diagnosis near the cutoff. We find that diagnosis and subsequent treatment of GDM resulted in improved outcomes at birth, in particular a significant reduction in the odds of being a macrosomic newborn. We also detect child BMI differences postnatally, but these fade out after 3 years of age; additionally, at five years of age, children of mothers diagnosed with GDM in pregnancy have reduced blood pressure. At age five, however, children of non-diagnosed mothers outperform those of GDM mothers in the Early Years Foundation Stage Profiles standardised test, a nationally-administered measure of school readiness. Hence, we confirm that treatment for GDM, as shown in the medical literature, improves outcomes of children at birth. However, we present for the first time evidence of potential adverse outcomes of treating GDM on children academic achievement five years later. Therefore, studies on long-run consequences of these GDM treatments on child development are urgently required.

Speaker: Paul Andrés Rodríguez Lesmes (Universitad del Rosario)

Discussant: Nicolai Vitt (University of Bristol)

Chair: Dorte Gyrd-Hansen (University of Southern Denmark)