Maternal Diabetes During Pregnancy Linked to Increased Epilepsy Risk in Offspring: Study
Canada: Researchers have found in a retrospective population-based study from Canada that children born to mothers with any form of diabetes—including type 1, type 2, or gestational diabetes—had a higher risk of developing epilepsy compared with children of non-diabetic mothers. The risk was greater among children whose mothers had a longer duration of type 1 or type 2 diabetes, suggesting a dose–response relationship.
Researchers noted that this association may be mediated by diabetes-related pregnancy complications rather than diabetes itself. The findings emphasize the importance of careful perinatal management and closer postnatal neurological surveillance for children exposed to maternal diabetes in utero.
The study, published in the journal Pediatrics, was led by Bénédicte Driollet, PhD, from the Department of Epidemiology, Biostatistics, and Occupational Health at McGill University, Canada, and colleagues. While maternal diabetes has been linked to several adverse neurodevelopmental outcomes, evidence specifically connecting it to epilepsy in offspring has remained limited and inconsistent. In particular, few studies have examined whether the risk differs across diabetes subtypes, which vary in etiology and metabolic impact.
To address this gap, the researchers conducted a large retrospective birth cohort study using linked maternal and child health records from Ontario, Canada’s most populous province. The cohort included all in-hospital live births between 2002 and 2018, with follow-up data available through March 2020. Children were followed until age 18 or until an epilepsy diagnosis, death, or end of follow-up.
Cox proportional hazards models were used to estimate the association between maternal diabetes subtypes and epilepsy risk, with additional analyses performed to assess the robustness of the findings.
The study led to the following findings:
- The analysis included over 2.1 million children, of whom about 160,600 (7.6%) were exposed to maternal diabetes during pregnancy.
- Among exposed pregnancies, 0.3% involved type 1 diabetes, 1.2% type 2 diabetes, and 6.1% gestational diabetes.
- Over a median follow-up of 10.2 years, nearly 17,900 children were diagnosed with epilepsy.
- After adjusting for maternal socioeconomic, demographic, and clinical factors, exposure to maternal diabetes was associated with a significantly higher risk of epilepsy in offspring.
- Increased epilepsy risk was observed across all diabetes subtypes.
- The strongest association was seen in children born to mothers with type 2 diabetes, followed by type 1 diabetes.
- Gestational diabetes was linked to a smaller but still statistically significant increase in epilepsy risk.
- Longer duration of maternal type 1 or type 2 diabetes was associated with a higher risk of epilepsy in children, suggesting a cumulative effect of prolonged metabolic dysregulation.
The authors suggest that the observed associations may be driven by prenatal metabolic and inflammatory exposures, as well as pregnancy complications commonly associated with diabetes, rather than by diabetes alone. Although causality cannot be established, the findings underscore the importance of optimizing glycemic control before and during pregnancy.
Overall, the study adds robust population-level evidence linking maternal diabetes to epilepsy risk in children and highlights the need for enhanced prenatal care and long-term neurological monitoring in this vulnerable population.
Reference:
Bénédicte Driollet, Asma M. Ahmed, Jennifer A. Hutcheon, Emmalin Buajitti, Laura Rosella, Seungmi Yang; Maternal Diabetes and Risk of Epilepsy in Offspring. Pediatrics 2026; e2025071138. 10.1542/peds.2025-071138
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