Perinatal risk factors for pediatric onset type 1 diabetes, autoimmune thyroiditis, juvenile idiopathic arthritis, and inflammatory bowel diseases
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Published on: May 6, 2013
Laura Räisänen1,2, Heli Viljakainen3,4, Catharina Sarkkola3
1Faculty of Medicine and Health Technology (MET), Tampere University, Tampere, Finland. laura.raisanen@tuni.fi.
Insights
Preterm birth is a risk factor for pediatric autoimmune diseases like type 1 diabetes and inflammatory bowel disease, especially with postnatal antibiotic use. High maternal age is linked to inflammatory bowel disease.
Area of Science:
- Pediatric autoimmune diseases
- Epidemiology
- Perinatal risk factors
Background:
- Type 1 diabetes mellitus (DM), autoimmune thyroiditis (AIT), juvenile idiopathic arthritis (JIA), and inflammatory bowel diseases (IBD) are common pediatric autoimmune conditions.
- Risk factors for these diseases remain largely unknown.
- Previous studies have not simultaneously investigated shared risk factors in a single cohort.
Purpose of the Study:
- To identify shared perinatal risk factors for common pediatric autoimmune diseases.
- To investigate the association between perinatal factors and the development of DM, AIT, JIA, and IBD in children.
Main Methods:
- Nationwide register-based cohort study.
- Followed 11,407 children born between 2000-2005 until 2018 (median follow-up 16.6 years).
- Analyzed perinatal data including birth status and postnatal antibiotic exposure.
Main Results:
- Preterm birth (< 37 weeks) was more frequent in children diagnosed with autoimmune diseases (8.6% vs. 5.3%).
- Preterm infants who developed autoimmune diseases received more postnatal antibiotics (47.6% vs. 27.7%).
- Higher maternal age at birth was associated with a diagnosis of IBD (33.0 vs. 30.2 years).
Conclusions:
- Preterm birth is a significant shared risk factor for pediatric autoimmune diseases, particularly when combined with postnatal antibiotic treatment.
- High maternal age is identified as a specific risk factor for inflammatory bowel disease.
- These findings highlight potential targets for early intervention and prevention strategies.
Abstract:
Type 1 diabetes mellitus (DM), autoimmune thyroiditis (AIT), juvenile idiopathic arthritis (JIA), and inflammatory bowel diseases (IBD) are common pediatric autoimmune diseases with unknown risk factors. Using nationwide registers, we searched for their perinatal risk factors. Our study followed up 11,407 children (born 2000-2005) for a median of 16.6 years (from birth to 2018). Of them, 2.15% received primary diagnosis and 0.08% also secondary: 0.89% had DM, 0.60% had AIT, 0.48% had JIA, and 0.25% had IBD. The incidences per 100,000 children/year were 106.1 for DM, 46.0 for AIT, 55.0 for JIA, and 23.7 for IBD. There were more preterm births (< 37 weeks) among children with studied autoimmune diseases compared with the rest of the cohort (8.6% vs. 5.3%, p = 0.035). Among those born preterm, children with studied autoimmune diseases received more postnatal antibiotics compared with other preterm children in the cohort (47.6% vs. 27.7%, p = 0.046). Children with IBD were born to older mothers compared with those without studied diagnoses (33.0 vs 30.2, p = 0.004).Conclusion: Preterm birth was a shared risk factor for autoimmune diseases in our study, especially when combined with postnatal antibiotic treatments. High maternal age was associated with IBD. What is Known: • Type 1 diabetes (DM), autoimmune thyroiditis (AIT), juvenile idiopathic arthritis (JIA), and inflammatory bowel diseases (IBD) are common pediatric autoimmune diseases • It is unclear whether these diseases have shared risk factors, since there are no previous simultaneous epidemiological nor follow-up studies on them in one cohort What is New: • Preterm births were more common in children with DM, AIT, JIA, or IBD compared with other children in the cohort, and preterm children who developed these diseases recieved more postnatal antibiotics compared with other preterm children • High maternal age was associated with IBD.
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