Preterm birth and risk of type 1 and type 2 diabetes: systematic review and meta‐analysis

Abstract

Preterm birth is suggested to play an important role in the development of diabetes. However, results have been inconsistent. We conducted a systematic review and meta-analysis to clarify the relationship between preterm birth and type 1 and type 2 diabetes. PubMed, Embase and ISI Web of Science were searched. A total of 18 studies (including 2,176,480 participants and 22,073 cases) for type 1 diabetes and five studies (including 31,478 participants and 1,898 cases) for type 2 diabetes were included in the current meta-analyses. We calculated pooled odds ratio (OR) and 95% confidence interval (CI) using fixed-effects model to evaluate the relations between preterm birth and type 1 and type 2 diabetes. The results suggested that preterm birth was significantly associated with increased risk of type 1 diabetes (OR = 1.18, 95% CI = 1.11-1.25), with no evidence of between-study heterogeneity (I(2) = 13.2%, P = 0.296). Preterm birth was also significantly associated with increased risk of type 2 diabetes (OR = 1.51, 95% CI = 1.32-1.72), with no evidence of (I(2) = 0.0%, P = 0.557). Subgroup analyses suggested that there was significant association in both case-control studies (OR = 1.16, 95% CI = 1.06-1.26) and cohort studies (relative risk = 1.20, 95% CI = 1.11-1.29) for type 1 diabetes, and similar results were found for type 2 diabetes. The results suggested that preterm birth was a significant and independent risk factor for both type 1 and type 2 diabetes.

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

“…It has been hypothesized that the effect of preterm and early-term birth on the risk of type 1 diabetes may be related to fetal growth restriction (7). Our data, however, do not support this hypothesis, as the association was unchanged when SGA children were excluded from the analysis.…”

“…In a recent meta-analysis of 14 case-control studies and four cohort studies, preterm birth (gestational age ,37 weeks) was found to increase the risk of type 1 diabetes by 18% (7). The authors highlighted several limitations in the literature such as a lack of consistent adjustment for important confounders.…”

Non-Communicable Chronic Diseases: The Role of Neonatal Characteristics

“…In contrast to our results, a meta-analysis, including a total of 18 studies for type I diabetes and 5 studies for type II diabetes, suggested that preterm birth was a significant and independent risk factor for both type I and type II diabetes (22). Finally, our data suggested that a premature birth plays a preventive role in becoming overweight or obese.…”

Preterm Birth and Subsequent Risk of Acute Childhood Leukemia: a Meta-Analysis of Observational Studies

“…While children born preterm were associated with increased incidence of diabetes, cardiovascular disease, respiratory disease, and neurological and psychiatric disorders in their adulthood life [3][4][5][6][7], one intriguing observation was about the prevalence of the childhood leukemia. Given the increasing number of children surviving preterm birth [29], any potential causal association between preterm birth and childhood leukemia could have a profound impact on public health issues.…”

“…Currently, low gestational age at birth has been recognized as a crucial long term risk factor for multiple non-communicable diseases. A growing body of evidence has demonstrated that preterm birth infants are at a higher risk of developing diabetes, cardiovascular disease, respiratory disease, and neurological and psychiatric disorders in their adult life [3][4][5][6][7].…”