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Diabetes 51:2568-2571, 2002
© 2002 by the American Diabetes Association, Inc.

Maternal First-Trimester Enterovirus Infection and Future Risk of Type 1 Diabetes in the Exposed Fetus

Hanna R. Viskari1, Merja Roivainen2, Antti Reunanen2, Janne Pitkäniemi2, Karita Sadeharju1, Pentti Koskela3, Tapani Hovi2, Pauli Leinikki2, Pekka Vilja1, Jaakko Tuomilehto2,4, and Heikki Hyöty1,5

1 Juvenile Diabetes Foundation International Center for the Prevention of type 1 diabetes in Finland and the Department of Virology, University of Tampere, Medical School, Tampere, Finland
2 National Public Health Institute, Helsinki, Finland
3 National Public Health Institute, Oulu, Finland
4 Department of Public Health, University of Helsinki, Helsinki, Finland
5 Department of Clinical Microbiology, Centre for Laboratory Medicine, Tampere University Hospital, Tampere, Finland

Previous studies have suggested that enterovirus infections during pregnancy may increase the risk of type 1 diabetes in the offspring. Our aim was to evaluate the role of first trimester enterovirus infections in a larger cohort of pregnant women. Two series of pregnant women were analyzed as follows: 948 women (series 1) and 680 women (series 2) whose child developed clinical diabetes before the ages of 15 or 7 years, respectively. An equal number of control women with a nondiabetic child was selected. Acute enterovirus infections were diagnosed by measuring IgM class antibodies against coxsackievirus B5 (series 1) and a mixture of coxsackievirus B3, coxsackievirus A16, and echovirus 11 antigens (series 2). In series 2, all sera were also analyzed for IgG class antibodies against an enterovirus peptide antigen. In addition, 152 randomly selected case-control pairs and all IgM-positive mothers’ sera were tested for enterovirus RNA (series 2). In series 1, 3.1% of case women had IgM antibodies against coxsackievirus B5 antigen compared with 4.1% of control women (NS). In series 2, 7.1% of case and 5.3% of control women had IgM against the mixture of enterovirus antigens (NS). IgG class enterovirus antibodies did not differ between the groups. Enterovirus RNA was found only in one case woman (0.3%) of the subgroup of samples and in 5.7% of 70 IgM-positive women. The results suggest that enterovirus infection during the first trimester of pregnancy is not associated with increased risk for type 1 diabetes in the child.



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