Perinatal factors and the risk of type 1 diabetes in childhood and adolescence-A register-based case-cohort study in Finland, years 1987 to 2009

Pediatr Diabetes. 2020 Jun;21(4):586-596. doi: 10.1111/pedi.12994. Epub 2020 Feb 8.

Abstract

Objectives: Our aim was to clarify previously reported associations and to explore new ones between various maternal background and perinatal factors and the risk of type 1 diabetes in childhood.

Methods: We identified all children born 1 January 1987 to 31 December 2008 in Finland and diagnosed with type 1 diabetes by age 16 years or end of 2009 from the Special Reimbursement Register (n = 6862). A 10% random sample from each birth year cohort was selected as a reference cohort (n = 127 216). Information on perinatal factors was obtained from the Finnish Medical Birth Register.

Results: Maternal diabetes (hazard ratios [HR] = 6.43; 95% confidence interval [CI] 5.35, 7.73), maternal asthma (HR = 1.23; 95% CI 1.06, 1.43), child's high birth length for gestational age (HR = 1.35; 95% CI 1.22, 1.51 highest vs lowest quintile) and premature or early term birth (HR = 1.21; 95% CI 1.05, 1.39 gestational weeks 33-36 and HR = 1.17; 95% CI 1.09, 1.26 gestational weeks 37-38 vs gestational weeks 39-40) was associated with an increased risk of type 1 diabetes when adjusted for several potential confounders. Maternal smoking during pregnancy (HR = 0.72; 95% CI 0.66, 0.77), high number of previous live births (HR = 0.65; 95% CI 0.55, 0.76 ≥ 4 vs 0 live births), and the child being born small for gestational age (HR = 0.80; 95% CI 0.67, 0.96) was associated with a decreased risk of type 1 diabetes.

Conclusions: Findings on maternal asthma and high birth length for gestational age increasing the risk of type 1 diabetes are novel and need to be confirmed. Our findings indicate that perinatal factors may play a role in the development of type 1 diabetes.

Keywords: birth length; child; cohort studies; diabetes mellitus type 1; gestational age.

Publication types

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

MeSH terms

  • Adolescent
  • Adult
  • Birth Weight / physiology
  • Body Height / physiology
  • Case-Control Studies
  • Child
  • Cohort Studies
  • Diabetes Mellitus, Type 1 / epidemiology*
  • Diabetes Mellitus, Type 1 / etiology*
  • Diabetes, Gestational / epidemiology
  • Female
  • Finland / epidemiology
  • History, 20th Century
  • History, 21st Century
  • Humans
  • Infant, Newborn
  • Male
  • Medical History Taking / statistics & numerical data
  • Mothers / statistics & numerical data
  • Pregnancy
  • Pregnancy Outcome / epidemiology*
  • Pregnancy in Diabetics / epidemiology
  • Premature Birth / epidemiology
  • Prenatal Exposure Delayed Effects / epidemiology*
  • Registries
  • Risk Factors
  • Young Adult