Maternal and neonatal risk factors for childhood type 1 diabetes: a matched case-control study

Abstract

BackgroundAn interaction between genetic susceptibility and environmental factors is thought to be involved in the aetiology of type 1 diabetes. The aim of this study was to investigate maternal and neonatal risk factors for type 1 diabetes in children under 15 years old in Grampian, Scotland.MethodsA matched case-control study was conducted by record linkage. Cases (n = 361) were children born in Aberdeen Maternity Hospital from 1972 to 2002, inclusive, who developed type 1 diabetes, identified from the Scottish Study Group for the Care of Diabetes in the Young Register. Controls (n = 1083) were randomly selected from the Aberdeen Maternity Neonatal Databank, matched by year of birth. Exposure data were obtained from the Aberdeen Maternity Neonatal Databank. Conditional logistic regression was used to evaluate the association between various maternal and neonatal factors and the risk of type 1 diabetes.ResultsThere was no evidence of statistically significant associations between type 1 diabetes and maternal age, maternal body mass index, previous abortions, pre-eclampsia, amniocentesis, maternal deprivation, use of syntocinon, mode of delivery, antepartum haemorrhage, baby's sex, gestational age at birth, birth order, birth weight, jaundice, phototherapy, breast feeding, admission to neonatal unit and Apgar score (P > 0.05). A significantly decreased risk of type 1 diabetes was observed in children whose mothers smoked at the booking appointment compared to those whose mothers did not, with an adjusted OR of 0.67, 95% CI (0.46, 0.99).ConclusionsThis case-control study found limited evidence of a reduced risk of the development of type 1 diabetes in children whose mothers smoked, compared to children whose mothers did not. No evidence was found of a significant association between other maternal and neonatal factors and childhood type 1 diabetes.

Maternal overweight and obesity are associated with increased risk of type 1 diabetes in offspring of parents without diabetes regardless of ethnicity

“…Maternal age was not a risk factor for type 1 diabetes in the offspring. This finding is in line with some previous studies [33,34], whereas others have reported increased risk with advanced maternal age [6,11]. The reasons behind these diverging results are unclear and need to be explored in future studies.…”

Gestational Age and Birth Weight and the Risk of Childhood Type 1 Diabetes: A Population-Based Cohort and Sibling Design Study

“…Our findings on low birth weight, however, are consistent with the meta-analysis, especially when we restricted the low-birth weight analysis to preterm births. Robertson and Harrild reported no association between maternal and neonatal risk factors including birth weight and gestational age and type 1 diabetes in a matched case-control study (23). It should be noted that they found increased odds of type 1 diabetes in children born preterm (,37 weeks) or with low birth weight (,2,500 g), although the results were not statistically significant.…”

“…It should be noted that they found increased odds of type 1 diabetes in children born preterm (,37 weeks) or with low birth weight (,2,500 g), although the results were not statistically significant. This suggests that the apparently inconsistent findings could be related to lack of adequate statistical power in Robertson and Harrild (23). Additionally, we categorized both birth weight and gestational age into more tightly defined groups including very low birth weight and very preterm birth, while they used preterm birth as ,37 weeks and low birth weight as ,2,500 g, which makes the comparison more complicated.…”

The prenatal environment and type 1 diabetes

“…The topic has never been systematically reviewed, but we identified at least 11 additional studies presenting data on this association in a comprehensive search, albeit with large heterogeneity in resolution and quality of data. Results were once again heterogeneous, but studies in which the information on maternal smoking in pregnancy was registered before or soon after birth (rather than by retrospective recall) tended to be consistent with the initial observation by Dahlquist and Källén [76][77][78][79]. We identified published data from four birth cohort studies with longitudinal follow-up for islet autoantibodies [62,63,80,81].…”