Birthweight and the risk of childhood-onset type 1 diabetes:a meta-analysis of observational studies using individual patient data

Cardwell, C. R. and Stene, L. C. and Joner, G. and Davis, E. A. and Cinek, O. and Rosenbauer, J. and Ludvigsson, J. and Castell, C. and Svensson, J. and Goldacre, M. J. and Waldhoer, T. and Polanska, J. and Gimeno, S. G. A. and Chuang, L. -M. and Parslow, R. C. and Wadsworth, E. J. K. and Chetwynd, A. and Pozzilli, P. and Brigis, G. and Urbonaite, B. and Sipetic, S. and Schober, E. and Ionescu-Tirgoviste, C. and de Beaufort, C. E. and Stoyanov, D. and Buschard, K. and Patterson, C. C. (2010) Birthweight and the risk of childhood-onset type 1 diabetes:a meta-analysis of observational studies using individual patient data. Diabetologia, 53 (4). pp. 641-651. ISSN 0012-186X

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We investigated whether children who are heavier at birth have an increased risk of type 1 diabetes. Relevant studies published before February 2009 were identified from literature searches using MEDLINE, Web of Science and EMBASE. Authors of all studies containing relevant data were contacted and asked to provide individual patient data or conduct pre-specified analyses. Risk estimates of type 1 diabetes by category of birthweight were calculated for each study, before and after adjustment for potential confounders. Meta-analysis techniques were then used to derive combined ORs and investigate heterogeneity between studies. Data were available for 29 predominantly European studies (five cohort, 24 case-control studies), including 12,807 cases of type 1 diabetes. Overall, studies consistently demonstrated that children with birthweight from 3.5 to 4 kg had an increased risk of diabetes of 6% (OR 1.06 [95% CI 1.01-1.11]; p = 0.02) and children with birthweight over 4 kg had an increased risk of 10% (OR 1.10 [95% CI 1.04-1.19]; p = 0.003), compared with children weighing 3.0 to 3.5 kg at birth. This corresponded to a linear increase in diabetes risk of 3% per 500 g increase in birthweight (OR 1.03 [95% CI 1.00-1.06]; p = 0.03). Adjustments for potential confounders such as gestational age, maternal age, birth order, Caesarean section, breastfeeding and maternal diabetes had little effect on these findings. Children who are heavier at birth have a significant and consistent, but relatively small increase in risk of type 1 diabetes.

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30 Nov 2011 10:03
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17 Sep 2023 00:59