MATERNAL diabetes is associated with an increased epilepsy risk in offspring, a 2026 retrospective cohort study has concluded.
Findings suggested that prenatal metabolic inflammatory exposures may contribute to the development of epilepsy.
Maternal Diabetes and Neurodevelopmental Disorders
Maternal diabetes (defined as type 1, type 2, or gestational diabetes) is one of the most frequent comorbidities among pregnant women. It is associated with adverse obstetric outcomes and neurodevelopmental disorders in offspring.
Evidence on the association between maternal diabetes and neurodevelopmental disorders in offspring, epilepsy in particular, is limited and heterogeneous.
The cause of epilepsy is unknown in approximately 50% of cases globally. The study contributes to growing evidence of the relevance of prenatal and perinatal exposures for the aetiology of epilepsy.
Increased Risk of Epilepsy
All in-hospital live births from 2002 to 2018 in Ontario, Canada, were analysed through several datasets linked using unique identifiers.
In more than two million children, 160,644 (7.6%) were exposed to maternal diabetes. Over a median follow-up of 10.2 years, more than 17,800 cases (0.8%) of epilepsy were diagnosed.
Children exposed to maternal diabetes had an increased risk of epilepsy in all diabetic subcategories, but particularly in type 1 and type 2 subcategories, compared with those unexposed. This was after adjusting for maternal socioeconomic and clinical characteristics.
The highest hazard ratio was observed for type 2 pregestational diabetes and a longer duration of maternal type 1 or type 2 diabetes tended to be associated with a higher risk of epilepsy in offspring.
Limitations and Clinical Implications
The use of administrative data could have led to potential misclassifications or residual and unmeasured confounding variables, although quantitative bias analyses were used to mitigate. It also prevented researchers from accessing more detailed data, such as epilepsy subtypes.
Researchers suggested that exposure to maternal diabetes may be one factor to consider when planning neurological follow-up in patients with epilepsy.
Reference
Driollet B et al. Maternal diabetes and risk of epilepsy in offspring. Pediatrics. 2026;doi: 10.1542/peds.2025-071138.
