Abstract
The objective was to investigate whether selected perinatal factors, as indicators of perinatal exposures, are associated with the risk of type 1 diabetes in children. Specifically, we tested whether maternal preeclampsia, Rhesus-immunization, induced labor, cesarean section, and multiple birth were associated with incidence of type 1 diabetes. A cohort study was designed by linking records of the Medical Birth Registry and the National Childhood Diabetes Registry of Norway. Live births in the study period were followed for a maximum of 15 y and contributed 8,166,731 person-years between 1989 and 1998. Altogether, 1824 cases of type 1 diabetes diagnosed between 1989 and 1998 were identified within the cohort. There was a suggestive, but nonsignificant, increase in risk of type 1 diabetes associated with Rhesus-immunization. Maternal preeclampsia, cesarean section, and the other perinatal factors investigated in this study were not significantly associated with incidence of type 1 diabetes in the children. Previous indications that cesarean section and preeclampsia are associated with type 1 diabetes were not supported by this large study. The majority of routinely recorded perinatal factors are only weakly associated with type 1 diabetes, or not at all.
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References
Atkinson MA, Maclaren NK 1994 The pathogenesis of insulin-dependent diabetes mellitus. N Engl J Med 24: 1428–1436
Leslie DG, Elliott RB 1994 Early environmental events as a cause of IDDM. Diabetes 43: 843–850
Stene LC, Magnus P, Lie RT, Søvik O, Joner G, the Norwegian Childhood Diabetes Study Group 2001 Birth weight and childhood onset type 1 diabetes: population based cohort study. BMJ 322: 889–892
Stene LC, Magnus P, Lie RT, Søvik O, Joner G, the Norwegian Childhood Diabetes Study Group 2001 Maternal and paternal age at delivery, birth order, and risk of childhood onset type 1 diabetes: population based cohort study. BMJ 323: 369–371
Dahlquist G, Källén B 1992 Maternal-child blood group incompatibility and other perinatal events increase the risk for early-onset type 1 (insulin-dependent) diabetes mellitus. Diabetologia 35: 671–675
Patterson CC, Carson DJ, Hadden DR, Waugh N, Cole SK 1994 A case-control investigation of perinatal risk factors for childhood IDDM in Northern Ireland and Scotland. Diabetes Care 17: 376–381
Jones ME, Swerdlow AJ, Gill LE, Goldacre MJ 1998 Pre-natal and early life risk factors for childhood onset diabetes mellitus: a record linkage study. Int J Epidemiol 27: 444–449
McKinney PA, Parslow R, Gurney KA, Law GR, Bodansky HJ, Williams R 1999 Perinatal and neonatal determinants of childhood type 1 diabetes: a case-control study in Yorkshire, U.K. Diabetes Care 22: 928–932
Dahlquist G, Patterson C, Stoltesz G 1999 Perinatal risk factors for childhood type 1 diabetes in Europe: the EURODIAB substudy 2 study group. Diabetes Care 22: 1698–1702
Grönlund MM, Lehtonen OP, Eerola E, Kero P 1999 Fecal microflora in healthy infants born by different methods of delivery: permanent changes in intestinal flora after cesarean delivery. J Pediatr Gastroenterol Nutr 28: 19–25
Grönlund MM, Nuutila J, Pelto L, Lilius EM, Isolauri E, Salminen S, Kero P, Lehtonen OP 1999 Mode of delivery directs the phagocyte functions of infants for the first 6 months of life. Clin Exp Immunol 116: 521–526
Bache I, Bock T, Vølund A, Buschard K 1999 Previous maternal abortion, longer gestation, and younger maternal age decease the risk of type 1 diabetes among male offspring. Diabetes Care 22: 1063–1065
EURODIAB ACE Study Group 2000 Variation and trends in incidence of childhood diabetes in Europe. Lancet 355: 873–876
Lie RT, Rasmussen S, Brunborg H, Gjessing HK, Lie-Nielsen E, Irgens LM 1998 Fetal and maternal contributions to risk of pre-eclampsia: population based study. BMJ 316: 1343–1347
Irgens LM 2000 The medical birth registry of Norway. Epidemiological research and surveillance throughout 30 years. Acta Obstet Gynecol Scand 79: 435–439
Stene LC 2001 Re: Implication of maternal age and birth order on type 1 diabetes; relevance in clinical practice? (eLetter). BMJ Available at: http://bmj.com/cgi/eletters/323/7309/369#EL4-
Preston DL, Lubin JH, Pierce DA, McConney ME 1993 Epicure User's Guide. Hirosoft International Corporation, Seattle
Persson B, Hanson U, Lunell N-O 1992 Diabetes mellitus and pregnancy. In: Alberti KG, DeFronzo RA, Keen H, Zimmet P(eds) International textbook of diabetes mellitus. John Wiley & Sons, Chichester, pp 1085–1101.
Kyvik KO, Green A, Beck-Nielsen H 1995 Concordance rates of insulin dependent diabetes mellitus: a population based study of young Danish twins. BMJ 311: 913–917
Morin-Papunen L, Tiilikainen A, Hartikainen-Sorri AL 1984 Maternal HLA immunization during pregnancy: presence of anti HLA antibodies in half of multigravidous women. Med Biol 62: 323–325
Karvonen M, Pitkaniemi M, Pitkaniemi J, Kohtamaki K, Tajima N, Tuomilehto J 1997 Sex difference in the incidence of insulin-dependent diabetes mellitus: an analysis of the recent epidemiological data. World Health Organization DIAMOND Project Group. Diabetes Metab Rev 13: 275–291
Joner G, Søvik O 1989 Increasing incidence of diabetes mellitus in Norwegian children 0–14 years of age 1973–1982. Diabetologia 32: 79–83
Joner G, Søvik O 1991 The incidence of type 1 (insulin-dependent) diabetes mellitus 15–29 years in Norway 1978–1982. Diabetologia 34: 271–274
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The authors thank the staff at the Medical Birth Registry for their assistance.
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APPENDIX
Members of the Norwegian Childhood Diabetes Study Group. Henning Aabech, Fredrikstad; Helge Vogt, Nordbyhagen; Knut Dahl-Jørgensen, Oslo; Hans-Jacob Bangstad, Oslo; Geir Joner, Oslo; Kolbeinn Gudmundsson, Oslo; Olav Flesvig, Elverum; Halvor Baevre, Lillehammer; Ola Talleraas, Lillehammer; Kjell Stensvold, Drammen; Bjørn Halvorsen, Tønsberg; Kristin Hodnekvam, Porsgrunn; Ole Kr. Danielsen, Arendal; Jorunn Ulriksen, Kristiansand; Geir Stangeland, Kristiansand; John Bland, Stavanger; Dag Roness, Haugesund; Oddmund Søvik, Bergen; Per Helge Kvistad, Førde; Steinar Spangen, Ålesund; Per Eirik Hæreid, Trondheim; Sigurd Børsting, Levanger; Dag Veimo, Bodø; Harald Dramsdahl, Harstad; Kersti Thodenius, Hammerfest.
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Stene, L., Magnus, P., Lie, R. et al. No Association between Preeclampsia or Cesarean Section and Incidence of Type 1 Diabetes among Children: A Large, Population-Based Cohort Study. Pediatr Res 54, 487–490 (2003). https://doi.org/10.1203/01.PDR.0000081301.25600.5D
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DOI: https://doi.org/10.1203/01.PDR.0000081301.25600.5D
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