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Relationship between increased relative birthweight and infections during pregnancy in children with a high-risk

H E Larsson1, K Lynch, B Lernmark

  • 1Department of Clinical Sciences, University Hospital MAS, Lund University, 205-02 Malmö, Sweden. helena.larsson@med.lu.se

Diabetologia
|April 5, 2007
PubMed

Insights

Maternal infections during pregnancy increase the risk of high birthweight in children, especially when islet autoantibodies are absent. Gestational infections also worsen the link between high-risk HLA genotypes and high birthweight.

Area of Science:

  • Immunology
  • Perinatology
  • Genetics

Background:

  • High-risk type 1 diabetes HLA genotypes are associated with increased offspring high relative birthweight (HrBW).
  • Cord blood islet autoantibodies are known to decrease HrBW risk.
  • Gestational infections are suspected to influence offspring type 1 diabetes risk.

Purpose of the Study:

  • To investigate if maternal gestational infections increase HrBW in offspring.
  • To determine if gestational infections mediate the protective effect of islet autoantibodies on HrBW.
  • To examine how gestational infections influence the association between HLA genotype and HrBW.

Main Methods:

  • Cord blood HLA genotypes and islet autoantibodies (GAD, IA-2, insulin) were analyzed in children from the Diabetes Prediction in Skåne (DiPiS) study.
  • Mothers of non-diabetic background reported gestational infections (fever, gastroenteritis) when their child was 2 months old.

Main Results:

  • Maternal reports of fever or gastroenteritis during pregnancy were linked to increased HrBW risk (p=0.0003).
  • This increased HrBW risk was particularly evident in the absence of cord blood islet autoantibodies (interaction p=0.0005).
  • Gestational infections aggravated the HrBW risk associated with high-risk HLA-DQ2/8 genotypes, especially when infections occurred in multiple trimesters (interaction p=0.022).

Conclusions:

  • Gestational infections (fever, gastroenteritis) are associated with an increased risk of high relative birthweight.
  • The protective effect of cord blood islet autoantibodies against HrBW was observed only when gestational infections were present.
  • Gestational infections exacerbate the association between high-risk HLA genotypes and high relative birthweight, suggesting complex interactions.
Abstract

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