OBJECTIVE: To identify environmental factors that exert their effect in the perinatal and neonatal period and influence the subsequent onset of insulin dependent (type 1) diabetes during childhood. RESEARCH DESIGN AND METHODS: A population-based case-control study of data abstracted from the hospital obstetric and neonatal records of 196 children with type 1 diabetes and 325 age- and sex-matched control subjects. Analysis of matched sets by conditional logistic regression was conducted for a range of perinatal and neonatal factors. RESULTS: A significantly raised risk was observed for illnesses in the neonatal period (OR 1.61, 95% CI 1.06-2.44), the majority of which were infections and respiratory difficulties. Exclusive breast feeding as the initial feeding method was significantly protective (OR 0.65, 95% CI 0.45-0.94). There were no significant associations with high- or low-birth weight, being firstborn or small-for-dates. All factors significant (5% level) for the entire dataset, that is, maternal age, type 1 diabetes in mothers, preeclampsia, delivery by cesarean section, neonatal illnesses, and initial breast feeding were modeled and the OR remained significant for all variables other than cesarean section. CONCLUSIONS: The findings are based on medical record data that cannot be subject to biased recall of mothers. Neonatal illnesses increased and initial breast feeding decreased the risk of childhood type 1 diabetes. Further determinants of risk are mothers with type 1 diabetes, older mothers, and preeclampsia during pregnancy.
OBJECTIVE: To identify environmental factors that exert their effect in the perinatal and neonatal period and influence the subsequent onset of insulin dependent (type 1) diabetes during childhood. RESEARCH DESIGN AND METHODS: A population-based case-control study of data abstracted from the hospital obstetric and neonatal records of 196 children with type 1 diabetes and 325 age- and sex-matched control subjects. Analysis of matched sets by conditional logistic regression was conducted for a range of perinatal and neonatal factors. RESULTS: A significantly raised risk was observed for illnesses in the neonatal period (OR 1.61, 95% CI 1.06-2.44), the majority of which were infections and respiratory difficulties. Exclusive breast feeding as the initial feeding method was significantly protective (OR 0.65, 95% CI 0.45-0.94). There were no significant associations with high- or low-birth weight, being firstborn or small-for-dates. All factors significant (5% level) for the entire dataset, that is, maternal age, type 1 diabetes in mothers, preeclampsia, delivery by cesarean section, neonatal illnesses, and initial breast feeding were modeled and the OR remained significant for all variables other than cesarean section. CONCLUSIONS: The findings are based on medical record data that cannot be subject to biased recall of mothers. Neonatal illnesses increased and initial breast feeding decreased the risk of childhood type 1 diabetes. Further determinants of risk are mothers with type 1 diabetes, older mothers, and preeclampsia during pregnancy.
Authors: N Lammi; E Moltchanova; P Blomstedt; J G Eriksson; O Taskinen; C Sarti; J Tuomilehto; M Karvonen Journal: Diabetologia Date: 2007-10-18 Impact factor: 10.122
Authors: C R Cardwell; L C Stene; G Joner; O Cinek; J Svensson; M J Goldacre; R C Parslow; P Pozzilli; G Brigis; D Stoyanov; B Urbonaite; S Sipetić; E Schober; C Ionescu-Tirgoviste; G Devoti; C E de Beaufort; K Buschard; C C Patterson Journal: Diabetologia Date: 2008-02-22 Impact factor: 10.122
Authors: Jason M Glanz; Christina L Clarke; Stanley Xu; Matthew F Daley; Jo Ann Shoup; Emily B Schroeder; Bruno J Lewin; David L McClure; Elyse Kharbanda; Nicola P Klein; Frank DeStefano Journal: JAMA Pediatr Date: 2020-05-01 Impact factor: 16.193
Authors: Chris R Cardwell; Lars C Stene; Geir Joner; Max K Bulsara; Ondrej Cinek; Joachim Rosenbauer; Johnny Ludvigsson; Mireia Jané; Jannet Svensson; Michael J Goldacre; Thomas Waldhoer; Przemyslawa Jarosz-Chobot; Suely G A Gimeno; Lee-Ming Chuang; Roger C Parslow; Emma J K Wadsworth; Amanda Chetwynd; Paolo Pozzilli; Girts Brigis; Brone Urbonaite; Sandra Sipetic; Edith Schober; Gabriele Devoti; Constantin Ionescu-Tirgoviste; Carine E de Beaufort; Denka Stoyanov; Karsten Buschard; Chris C Patterson Journal: Diabetes Date: 2009-10-29 Impact factor: 9.461