Tine Dalsgaard Clausen1, Thomas Bergholt, Frank Eriksson, Steen Rasmussen, Niels Keiding, Ellen C Løkkegaard. 1. From the aDepartment of Gynecology and Obstetrics, Nordsjællands Hospital, University of Copenhagen, Hillerød, Denmark; bSection of Biostatistics, Department of Public Health, University of Copenhagen, Copenhagen, Denmark; and cDepartment of Microbiology, Hvidovre Hospital, Copenhagen, Denmark.
Abstract
BACKGROUND: Unfavorable conditions associated with cesarean section may influence the risk of type 1 diabetes in offspring, but results from studies are conflicting. We aimed to evaluate the association between prelabor cesarean section and risk of childhood type 1 diabetes. METHODS: A Danish nationwide cohort study followed all singletons born during 1982-2010. Four national registers provided information on mode of delivery, outcome, and confounders. The risk of childhood type 1 diabetes with onset before the age of 15 years was assessed by Cox regression. A total of 1,760,336 singletons contributed 20,436,684 person-years, during which 4,400 were diagnosed with childhood type 1 diabetes. RESULTS: The hazard ratio (HR) for childhood type 1 diabetes was increased in children delivered by prelabor cesarean section compared with vaginal delivery when adjusted for year of birth, parity, sex, parental age, and education and paternal type 1 diabetes status at childbirth (HR = 1.2; 95% confidence interval [CI] = 1.0, 1.3), but not after additional adjustment for maternal type 1 diabetes status at childbirth (HR = 1.1; 95% CI = 0.95, 1.2). Delivery by intrapartum cesarean section was not associated with childhood type 1 diabetes. Paternal type 1 diabetes was a stronger risk factor for childhood type 1 (HR = 12; 95% CI = 10, 14) than maternal type 1 diabetes (HR = 6.5; 95% CI = 5.2, 8.0). CONCLUSIONS: Delivery by prelabor cesarean section was not associated with an increased risk of childhood type 1 diabetes in the offspring.
BACKGROUND: Unfavorable conditions associated with cesarean section may influence the risk of type 1 diabetes in offspring, but results from studies are conflicting. We aimed to evaluate the association between prelabor cesarean section and risk of childhood type 1 diabetes. METHODS: A Danish nationwide cohort study followed all singletons born during 1982-2010. Four national registers provided information on mode of delivery, outcome, and confounders. The risk of childhood type 1 diabetes with onset before the age of 15 years was assessed by Cox regression. A total of 1,760,336 singletons contributed 20,436,684 person-years, during which 4,400 were diagnosed with childhood type 1 diabetes. RESULTS: The hazard ratio (HR) for childhood type 1 diabetes was increased in children delivered by prelabor cesarean section compared with vaginal delivery when adjusted for year of birth, parity, sex, parental age, and education and paternal type 1 diabetes status at childbirth (HR = 1.2; 95% confidence interval [CI] = 1.0, 1.3), but not after additional adjustment for maternal type 1 diabetes status at childbirth (HR = 1.1; 95% CI = 0.95, 1.2). Delivery by intrapartum cesarean section was not associated with childhood type 1 diabetes. Paternal type 1 diabetes was a stronger risk factor for childhood type 1 (HR = 12; 95% CI = 10, 14) than maternal type 1 diabetes (HR = 6.5; 95% CI = 5.2, 8.0). CONCLUSIONS: Delivery by prelabor cesarean section was not associated with an increased risk of childhood type 1 diabetes in the offspring.
Authors: Lilian L Peters; Charlene Thornton; Ank de Jonge; Ali Khashan; Mark Tracy; Soo Downe; Esther I Feijen-de Jong; Hannah G Dahlen Journal: Birth Date: 2018-03-25 Impact factor: 3.689
Authors: Tine D Clausen; Thomas Bergholt; Olivier Bouaziz; Magnus Arpi; Frank Eriksson; Steen Rasmussen; Niels Keiding; Ellen C Løkkegaard Journal: PLoS One Date: 2016-08-25 Impact factor: 3.240
Authors: Pieter F de Groot; Clara Belzer; Ömrüm Aydin; Evgeni Levin; Johannes H Levels; Steven Aalvink; Fransje Boot; Frits Holleman; Daniël H van Raalte; Torsten P Scheithauer; Suat Simsek; Frank G Schaap; Steven W M Olde Damink; Bart O Roep; Joost B Hoekstra; Willem M de Vos; Max Nieuwdorp Journal: PLoS One Date: 2017-12-06 Impact factor: 3.240