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All Journal Scientia Psychiatrica Sriwijaya Journal of Neurology
Vania Delma
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Biochemistry, Genetics & Molecular Biology Dentistry Health Professions Medicine & Pharmacology Neuroscience Public Health

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The Impact of Gestational Diabetes on Long-Term Cognitive Function: A Prospective Cohort Study with Neuroimaging Correlates in Bandung, Indonesia Miranda Aisah; Lestini Wulansari; Vania Delma; Reza Andrianto; Zahra Amir; Dedi Sucipto; Agnes Mariska; Saurie Hernandez
Sriwijaya Journal of Neurology Vol. 2 No. 1 (2024): Sriwijaya Journal of Neurology
Publisher : Phlox Institute: Indonesian Medical Research Organization

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59345/sjn.v1i2.91

Abstract

Introduction: Gestational diabetes mellitus (GDM) is a growing public health concern with potential long-term consequences for both mother and child. Emerging evidence suggests that GDM may impact maternal cognitive function, but the underlying mechanisms remain unclear. This prospective cohort study investigates the association between GDM and long-term cognitive function in mothers, exploring potential neuroimaging correlates. Methods: Pregnant women were recruited from antenatal clinics in Bandung, Indonesia, between 2018 and 2020. GDM was diagnosed using the International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria. Cognitive function was assessed at 6 months, 1 year, and 3 years postpartum using a comprehensive neuropsychological battery. A subset of participants underwent structural and functional magnetic resonance imaging (MRI) at 3 years postpartum. Results: Women with GDM exhibited lower scores on tests of executive function, processing speed, and memory compared to women without GDM at all follow-up assessments. MRI analysis revealed alterations in brain structure and function inwomen with a history of GDM, including reduced gray matter volume in the prefrontal cortex and hippocampus, and altered functional connectivity within the default mode network. Conclusion: GDM is associated with long-term cognitive impairment in mothers, possibly mediated by structural and functional brain changes. These findings highlight the importance of early identification and management of GDM to mitigate potential long-term cognitive consequences.
Buffering Effects of Extended Family: A Moderated Mediation Analysis of Maternal Depression, Parenting Stress, and Early Childhood Development in West Java, Indonesia Habiburrahman Said; Novalika Kurnia; Aline Hafidzah; Vania Delma; Fachrudin Sani
Scientia Psychiatrica Vol. 6 No. 2 (2025): Scientia Psychiatrica
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/scipsy.v6i2.201

Abstract

Introduction: In low- and middle-income countries (LMICs), maternal mental health significantly impacts early childhood development (ECD). West Java, Indonesia, presents a unique cultural context where extended family involvement is ubiquitous. This study aims to elucidate the mechanism linking maternal depressive symptoms to early childhood developmental delays, focusing on the mediating role of parenting stress and the moderating role of social support from extended family. Methods: A cross-sectional analytical study was conducted in five regencies of West Java (N = 842 mother-child dyads). Children were aged 12–36 months. We utilized the Edinburgh Postnatal Depression Scale (EPDS) for depressive symptoms, the Parenting Stress Index-Short Form (PSI-SF) for stress, the Multidimensional Scale of Perceived Social Support (MSPSS) adapted for extended family, and the Ages and Stages Questionnaire (ASQ-3) for developmental monitoring. A moderated mediation model (Hayes Model 7) was tested using Structural Equation Modeling (SEM) with 5,000 bootstrap samples. Results: High maternal depressive symptoms were significantly associated with lower ECD scores (β = -0.42, p < 0.001). Parenting stress partially mediated this relationship (Indirect Effect = -0.18, 95% CI [-0.24, -0.13]). Crucially, extended family support moderated the path between depression and parenting stress (β = -0.15, p < 0.01). Specifically, the impact of depression on parenting stress was significantly dampened in households with high extended family engagement compared to those with low support. Conclusion: Parenting stress is a critical pathway through which maternal depression compromises child development. However, the collectivist family structure in West Java serves as a protective buffer. Interventions should target not only the mother but also mobilize the extended family network as a resource for 'kalyana mitra' (supportive friends/family).
Co-Authors Agnes Mariska Aline Hafidzah Dedi Sucipto Fachrudin Sani Habiburrahman Said Lestini Wulansari Miranda Aisah Novalika Kurnia Reza Andrianto Saurie Hernandez Zahra Amir