velopment in South African

children?

(2022). Cognitive and Motor Development in 3- to 6-Year-Old Children Born to Mothers with Hyperglycaemia First Detected in Pregnancy in an Urban African Population. Maternal and Child Health Journal. https://doi.org/10.1007/s10995-021-03331-z

Soepnel, L. M.,

Hyperglycaemia (high blood glucose) during pregnancy may have deleterious effects on foetal neurodevelopment with the potential to impact longerterm cognitive development through childhood. However, little research has been conducted in South African mothers and children utilizing public healthcare facilities.

Between March and November 2019, Dr Larske Soepnel, a post-doctoral fellow at the University of Witwatersrand, recruited mothers and children at the Chris Hani Baragwanath Academic Hospital (CHBAH) in Soweto. Using the Herbst Early Childhood Development Criteria test, the cognitive abilities of 95 children born to mothers with hyperglycaemia first detected in pregnancy (HFDP) were compared to 99 children who had not been exposed to maternal HFDP.

In the cognitive subsection of the test, infants who were born at term and exposed to hyperglycaemia utero scored “high” in 24.3% of cases and “low” in 25.7% of cases, compared to 37.7% and 12.9 percent in the HFDP-unexposed group, respectively. For children born atterm, ordinal regression analysis with known confounders showed that cognitive development in pre-school children was inversely correlated with exposure to HFDP.

The authors concluded that more children could achieve their developmental potential if women’s health before and during pregnancy is optimised, including glucose control during pregnancy.

Does maternal hyperglycaemia impact the blood pressure of South African children?

Journal of Hypertension, 40(5), 969–977. https://doi.org/10.1097/HJH.0000000000003102

Continuing in the same vein, Brittany Boersta, a Master’s graduate from Utrecht University, investigated the relationship between maternal HFDP and children’s blood pressure in Soweto, South Africa, among children aged 3 to 6 years. Maternal hyperglycemia during pregnancy was retrospectively determined using hospital records and blood pressure was measured in 189 children in Soweto.

While half (49.7%) of the children exhibited elevated blood pressure, this was not found to be associated with maternal hyperglycemia when adjusted offspring age, height, and sex or after multivariable adjustment. However, the child’s BMI for age z-score was a significant predictor of systolic blood pressure in childhood.

Although childhood blood pressure does not seem related to maternal hyperglycaemia, the high incidence of raised blood pressure in this group of preschool children is alarming. Further work is needed to develop interventions for childhood obesity as a modifiable risk factor for lowering blood pressure and cardiovascular risk in an African paediatric context.

Early life growth is known to be a key indicator and influencer of early child development. Whether this growth mediates relationships between maternal education and socioeconomic status and child development is not clear.

Dr Wiedaad Slemming, a postdoctoral researcher at the University of Witwatersrand, analysed retrospective data from the South African Birth to Thirty cohort study to examine the maternal education and socioeconomic status (SES) of the household during pregnancy and the first two years of life, with growth data collected between birth and 4 years of age. Parents or caregivers completed a Revised Denver Pre-screening Devel- opmental Questionnaire (R-DPDQ) when their children were age 5.

Findings showed that higher birthweight and household SES were associated with higher development scores in both boys and girls. Higher linear growth in boys, especially between 0 and 2 years, was associated with higher development scores at age 5. Growth status but not SES mediated the association between maternal education and development scores suggesting that the negative effects of lower maternal education on child development could be attenuated by better growth in the early years.