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Perinatal and neonatal determinants of childhood type 1 diabetes. A case-control study in Yorkshire, U.K.

Abstract

OBJECTIVE

To identify environmental factors that exert their effect in the perinatal and neonatal period and influence the subsequent onset of insulin dependent (type 1) diabetes during childhood.

RESEARCH DESIGN AND METHODS

A population-based case-control study of data abstracted from the hospital obstetric and neonatal records of 196 children with type 1 diabetes and 325 age- and sex-matched control subjects. Analysis of matched sets by conditional logistic regression was conducted for a range of perinatal and neonatal factors.

RESULTS

A significantly raised risk was observed for illnesses in the neonatal period (OR 1.61, 95% CI 1.06-2.44), the majority of which were infections and respiratory difficulties. Exclusive breast feeding as the initial feeding method was significantly protective (OR 0.65, 95% CI 0.45-0.94). There were no significant associations with high- or low-birth weight, being firstborn or small-for-dates. All factors significant (5% level) for the entire dataset, that is, maternal age, type 1 diabetes in mothers, preeclampsia, delivery by cesarean section, neonatal illnesses, and initial breast feeding were modeled and the OR remained significant for all variables other than cesarean section.

CONCLUSIONS

The findings are based on medical record data that cannot be subject to biased recall of mothers. Neonatal illnesses increased and initial breast feeding decreased the risk of childhood type 1 diabetes. Further determinants of risk are mothers with type 1 diabetes, older mothers, and preeclampsia during pregnancy.

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  • Authors+Show Affiliations

    ,

    Paediatric Epidemiology Group, University of Leeds, U.K.

    , , , ,

    Source

    Diabetes care 22:6 1999 Jun pg 928-32

    MeSH

    Adolescent
    Breast Feeding
    Case-Control Studies
    Cesarean Section
    Child
    Child, Preschool
    Diabetes Mellitus, Type 1
    England
    Environment
    Female
    Humans
    Infant
    Infant, Newborn
    Male
    Maternal Age
    Multivariate Analysis
    Pre-Eclampsia
    Pregnancy
    Pregnancy in Diabetics
    Regression Analysis
    Risk Factors

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    10372244

    Citation

    McKinney, P A., et al. "Perinatal and Neonatal Determinants of Childhood Type 1 Diabetes. a Case-control Study in Yorkshire, U.K." Diabetes Care, vol. 22, no. 6, 1999, pp. 928-32.
    McKinney PA, Parslow R, Gurney KA, et al. Perinatal and neonatal determinants of childhood type 1 diabetes. A case-control study in Yorkshire, U.K. Diabetes Care. 1999;22(6):928-32.
    McKinney, P. A., Parslow, R., Gurney, K. A., Law, G. R., Bodansky, H. J., & Williams, R. (1999). Perinatal and neonatal determinants of childhood type 1 diabetes. A case-control study in Yorkshire, U.K. Diabetes Care, 22(6), pp. 928-32.
    McKinney PA, et al. Perinatal and Neonatal Determinants of Childhood Type 1 Diabetes. a Case-control Study in Yorkshire, U.K. Diabetes Care. 1999;22(6):928-32. PubMed PMID: 10372244.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Perinatal and neonatal determinants of childhood type 1 diabetes. A case-control study in Yorkshire, U.K. AU - McKinney,P A, AU - Parslow,R, AU - Gurney,K A, AU - Law,G R, AU - Bodansky,H J, AU - Williams,R, PY - 1999/6/18/pubmed PY - 1999/6/18/medline PY - 1999/6/18/entrez SP - 928 EP - 32 JF - Diabetes care JO - Diabetes Care VL - 22 IS - 6 N2 - OBJECTIVE: To identify environmental factors that exert their effect in the perinatal and neonatal period and influence the subsequent onset of insulin dependent (type 1) diabetes during childhood. RESEARCH DESIGN AND METHODS: A population-based case-control study of data abstracted from the hospital obstetric and neonatal records of 196 children with type 1 diabetes and 325 age- and sex-matched control subjects. Analysis of matched sets by conditional logistic regression was conducted for a range of perinatal and neonatal factors. RESULTS: A significantly raised risk was observed for illnesses in the neonatal period (OR 1.61, 95% CI 1.06-2.44), the majority of which were infections and respiratory difficulties. Exclusive breast feeding as the initial feeding method was significantly protective (OR 0.65, 95% CI 0.45-0.94). There were no significant associations with high- or low-birth weight, being firstborn or small-for-dates. All factors significant (5% level) for the entire dataset, that is, maternal age, type 1 diabetes in mothers, preeclampsia, delivery by cesarean section, neonatal illnesses, and initial breast feeding were modeled and the OR remained significant for all variables other than cesarean section. CONCLUSIONS: The findings are based on medical record data that cannot be subject to biased recall of mothers. Neonatal illnesses increased and initial breast feeding decreased the risk of childhood type 1 diabetes. Further determinants of risk are mothers with type 1 diabetes, older mothers, and preeclampsia during pregnancy. SN - 0149-5992 UR - https://www.unboundmedicine.com/medline/citation/10372244/Perinatal_and_neonatal_determinants_of_childhood_type_1_diabetes__A_case_control_study_in_Yorkshire_U_K_ L2 - http://care.diabetesjournals.org/cgi/pmidlookup?view=long&pmid=10372244 DB - PRIME DP - Unbound Medicine ER -