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Intrauterine growth pattern and risk of childhood onset insulin dependent (type I) diabetes: population based
G Dahlquist1, S S Bennich, B Källén
1Department of Paediatrics, University of Umeå, Sweden.
Insights
Prenatal growth impacts childhood diabetes risk. Poor fetal growth may decrease risk, while excess growth increases it, though the exact mechanism remains unknown.
Area of Science:
- Pediatrics
- Endocrinology
- Epidemiology
Background:
- Childhood onset insulin-dependent diabetes mellitus (type 1 diabetes) is a significant health concern.
- Understanding risk factors for type 1 diabetes is crucial for prevention and early intervention.
Purpose of the Study:
- To investigate the association between prenatal growth patterns and the risk of developing childhood onset insulin-dependent diabetes mellitus.
Main Methods:
- A population-based case-control study utilizing Swedish national registers.
- Inclusion of 4584 children diagnosed with insulin-dependent diabetes and matched controls.
- Analysis of birth weight, gestational age, and maternal factors.
Main Results:
- A significant trend was observed between birth weight standard deviation (SD) and diabetes risk.
- Children small for gestational age had a reduced odds ratio (0.81) for diabetes.
- Children large for gestational age had an increased odds ratio (1.20) for diabetes.
Conclusions:
- Intrauterine conditions influencing prenatal growth appear to affect childhood diabetes risk.
- Poor prenatal growth is associated with decreased risk, while excess growth is associated with increased risk.
- The underlying biological mechanisms for this association require further investigation.
Objective:
To investigate whether prenatal growth affects the risk of development of childhood onset insulin dependent (type I) diabetes mellitus.
Design:
Population based case-control study.
Setting:
Data from a nationwide childhood diabetes case register were linked with data from the nationwide Swedish Medical Birth Registry.
Subjects:
Data from a total of 4584 diabetic children born after 1973 and diagnosed with diabetes from 1978 to 1992 were studied. For each child with insulin dependent diabetes three control children were randomly selected from among all infants born in the same year and at the same hospital as the proband.
Main Outcome Measures:
Birth weight, gestation, maternal age and parity, number of previous spontaneous abortions, and sex specific birth weight by gestational week expressed as multiples of the standard deviation (SD).
Results:
There was a clear trend in the odds ratio for childhood onset diabetes according to SD of birth weight. The odds ratio (95% confidence interval) for small for gestational age after stratification for maternal age, parity, smoking habits, and maternal diabetes was 0.81 (0.65 to 0.99) and for large for gestational age after similar stratification was 1.20 (1.02 to 1.42).
Conclusions:
Intrauterine conditions that affect prenatal growth seem also to affect the risk of development of childhood diabetes in the way previously described for postnatal growth: a poor growth decreases and an excess growth increases the risk. The mechanism for this association is unclear.