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Gestational Age and Birth Weight and the Risk of Childhood Type 1 Diabetes: A Population-Based Cohort and Sibling Design Study.
Diabetes Care 2015; 38(12):2308-15DC

Abstract

OBJECTIVE

We investigated the effects of gestational age, birth weight, small for gestational age (SGA), and large for gestational age (LGA) on risk of childhood type 1 diabetes.

RESEARCH DESIGN AND METHODS

We conducted a population-based cohort study of all singleton live births in Sweden between 1973 and 2009 and a sibling control study. Perinatal data were extracted from the Swedish Medical Birth Register. Children with type 1 diabetes diagnosis were identified from the Swedish National Patient Register. Log-linear Poisson regression and conditional logistic regression were used for data analysis.

RESULTS

The study cohort consisted of 3,624,675 singleton live births (42,411,054 person-years). There were 13,944 type 1 diabetes cases during the study period. The sibling control study consisted of 11,403 children with type 1 diabetes and 17,920 siblings. Gestational age between 33 and 36 weeks (relative risk [RR] 1.18 [95% CI 1.09, 1.28) and 37 and 38 weeks (RR 1.12 [95% CI 1.07, 1.17]) was associated with type 1 diabetes in the cohort study and remained significant in the sibling control study. SGA (RR 0.83 [95% CI 0.75, 0.93]) and LGA (RR 1.14 [95% CI 1.04, 1.24]) were associated with type 1 diabetes in the cohort study. The SGA association remained unchanged in the sibling study, while the LGA association disappeared. Very low birth weight was associated with a reduced risk of type 1 diabetes.

CONCLUSIONS

The findings suggest a small association between gestational age and type 1 diabetes that is not likely due to familial confounding factors. Gestational age and type 1 diabetes may be related to insulin resistance due to early life growth restriction or altered gut microbiota in preterm babies.

Authors+Show Affiliations

Department of Epidemiology and Public Health, University College Cork, Cork, Ireland The Irish Centre for Fetal and Neonatal Translational Research, Department of Obstetrics and Gynaecology, University College Cork, Cork, Ireland a.khashan@ucc.ie.The Irish Centre for Fetal and Neonatal Translational Research, Department of Obstetrics and Gynaecology, University College Cork, Cork, Ireland.Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.Department of Epidemiology and Public Health, University College Cork, Cork, Ireland.Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.Centre for Biostatistics, Institute of Population Health, University of Manchester, Manchester, U.K.Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden Astrid Lindgren Children's Hospital, Lung and Allergy Unit, Karolinska University Hospital, Stockholm, Sweden.

Pub Type(s)

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

Language

eng

PubMed ID

26519334

Citation

Khashan, Ali S., et al. "Gestational Age and Birth Weight and the Risk of Childhood Type 1 Diabetes: a Population-Based Cohort and Sibling Design Study." Diabetes Care, vol. 38, no. 12, 2015, pp. 2308-15.
Khashan AS, Kenny LC, Lundholm C, et al. Gestational Age and Birth Weight and the Risk of Childhood Type 1 Diabetes: A Population-Based Cohort and Sibling Design Study. Diabetes Care. 2015;38(12):2308-15.
Khashan, A. S., Kenny, L. C., Lundholm, C., Kearney, P. M., Gong, T., McNamee, R., & Almqvist, C. (2015). Gestational Age and Birth Weight and the Risk of Childhood Type 1 Diabetes: A Population-Based Cohort and Sibling Design Study. Diabetes Care, 38(12), pp. 2308-15. doi:10.2337/dc15-0897.
Khashan AS, et al. Gestational Age and Birth Weight and the Risk of Childhood Type 1 Diabetes: a Population-Based Cohort and Sibling Design Study. Diabetes Care. 2015;38(12):2308-15. PubMed PMID: 26519334.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Gestational Age and Birth Weight and the Risk of Childhood Type 1 Diabetes: A Population-Based Cohort and Sibling Design Study. AU - Khashan,Ali S, AU - Kenny,Louise C, AU - Lundholm,Cecilia, AU - Kearney,Patricia M, AU - Gong,Tong, AU - McNamee,Roseanne, AU - Almqvist,Catarina, Y1 - 2015/10/30/ PY - 2015/04/27/received PY - 2015/08/30/accepted PY - 2015/11/1/entrez PY - 2015/11/1/pubmed PY - 2016/6/28/medline SP - 2308 EP - 15 JF - Diabetes care JO - Diabetes Care VL - 38 IS - 12 N2 - OBJECTIVE: We investigated the effects of gestational age, birth weight, small for gestational age (SGA), and large for gestational age (LGA) on risk of childhood type 1 diabetes. RESEARCH DESIGN AND METHODS: We conducted a population-based cohort study of all singleton live births in Sweden between 1973 and 2009 and a sibling control study. Perinatal data were extracted from the Swedish Medical Birth Register. Children with type 1 diabetes diagnosis were identified from the Swedish National Patient Register. Log-linear Poisson regression and conditional logistic regression were used for data analysis. RESULTS: The study cohort consisted of 3,624,675 singleton live births (42,411,054 person-years). There were 13,944 type 1 diabetes cases during the study period. The sibling control study consisted of 11,403 children with type 1 diabetes and 17,920 siblings. Gestational age between 33 and 36 weeks (relative risk [RR] 1.18 [95% CI 1.09, 1.28) and 37 and 38 weeks (RR 1.12 [95% CI 1.07, 1.17]) was associated with type 1 diabetes in the cohort study and remained significant in the sibling control study. SGA (RR 0.83 [95% CI 0.75, 0.93]) and LGA (RR 1.14 [95% CI 1.04, 1.24]) were associated with type 1 diabetes in the cohort study. The SGA association remained unchanged in the sibling study, while the LGA association disappeared. Very low birth weight was associated with a reduced risk of type 1 diabetes. CONCLUSIONS: The findings suggest a small association between gestational age and type 1 diabetes that is not likely due to familial confounding factors. Gestational age and type 1 diabetes may be related to insulin resistance due to early life growth restriction or altered gut microbiota in preterm babies. SN - 1935-5548 UR - https://www.unboundmedicine.com/medline/citation/26519334/Gestational_Age_and_Birth_Weight_and_the_Risk_of_Childhood_Type_1_Diabetes:_A_Population_Based_Cohort_and_Sibling_Design_Study_ L2 - http://care.diabetesjournals.org/cgi/pmidlookup?view=long&pmid=26519334 DB - PRIME DP - Unbound Medicine ER -