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Meta-Analysis
. 2018 Dec;146(16):2131-2138.
doi: 10.1017/S0950268818002455. Epub 2018 Aug 28.

Maternal infection during pregnancy and type 1 diabetes mellitus in offspring: a systematic review and meta-analysis

Y Yue  1 , Y Tang  2 , J Tang  1 , J Shi  1 , T Zhu  1 , J Huang  1 , X Qiu  1 , Y Zeng  1 , W Li  1 , Y Qu  1 , D Mu  1
Affiliations
Free PMC article
Meta-Analysis

Maternal infection during pregnancy and type 1 diabetes mellitus in offspring: a systematic review and meta-analysis

Y Yue et al. Epidemiol Infect. 2018 Dec.
Free PMC article

Abstract

Previous studies have demonstrated that type 1 diabetes mellitus (T1DM) could be triggered by an early childhood infection. Whether maternal infection during pregnancy is associated with T1DM in offspring is unknown. Therefore, we aimed to study the association using a systematic review and meta-analysis. Eighteen studies including 4304 cases and 25 846 participants were enrolled in this meta-analysis. Odds ratios (ORs) and 95% confidence intervals (CIs) were synthesised using random-effects models. Subgroup analyses and sensitivity analyses were conducted to assess the robustness of associations. Overall, the pooled analysis yielded a statistically significant association between maternal infection during pregnancy and childhood T1DM (OR 1.31, 95% CI 1.07-1.62). Furthermore, six studies that tested maternal enterovirus infection showed a pooled OR of 1.54 (95% CI 1.05-2.27). Heterogeneity from different studies was evident (I2 = 70.1%, P < 0.001) and was mainly attributable to the different study designs, ascertaining methods and sample size among different studies. This study provides evidence for an association between maternal infection during pregnancy and childhood T1DM.

Keywords: Maternal infection; meta-analysis; observational studies; type 1 diabetes mellitus.

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Conflict of interest statement

None.

Figures

Fig. 1.
Fig. 1.
Flow diagram of the study selection process.
Fig. 2.
Fig. 2.
Forest plot of odds ratios for the association between maternal infection during pregnancy and T1DM or islet autoimmunity in the offspring. Weights are from the random-effects analysis. ES, effect size.
Fig. 3.
Fig. 3.
Funnel plot of the association between maternal infection and T1DM or islet autoimmunity in the offspring.
See this image and copyright information in PMC

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