Interbirth Interval Is Associated With Childhood Type 1 Diabetes Risk

Chris R. Cardwell; Jannet Svensson; Thomas Waldhoer; Johnny Ludvigsson; Vaiva Sadauskaitė-Kuehne; Christine L. Roberts; Roger C. Parslow; Emma J.K. Wadsworth; Girts Brigis; Brone Urbonaitė; Edith Schober; Gabriele Devoti; Constantin Ionescu-Tirgoviste; Carine E. de Beaufort; Gyula Soltesz; Chris C. Patterson

doi:10.2337/db11-1000

Pathophysiology

Interbirth Interval Is Associated With Childhood Type 1 Diabetes Risk

Chris R. Cardwell¹ ⇓,
Jannet Svensson²,
Thomas Waldhoer³,
Johnny Ludvigsson⁴,
Vaiva Sadauskaitė-Kuehne⁵,
Christine L. Roberts⁶,
Roger C. Parslow⁷,
Emma J.K. Wadsworth⁸,
Girts Brigis⁹,
Brone Urbonaitė¹⁰,
Edith Schober¹¹,
Gabriele Devoti¹²,
Constantin Ionescu-Tirgoviste¹³,
Carine E. de Beaufort¹⁴,
Gyula Soltesz¹⁵ and
Chris C. Patterson¹

¹Centre for Public Health, Queen’s University Belfast, Belfast, U.K.
²Pediatric Department, Glostrup University Hospital, Glostrup, Denmark
³Department of Epidemiology, Medical University of Vienna, Vienna, Austria
⁴Department of Paediatrics and Diabetes Research Centre, Linkoping University, Linkoping, Sweden
⁵Institute of Endocrinology of Lithuanian University of Health Science, Kaunas, Lithuania
⁶Kolling Institute of Medical Research, University of Sydney, Sydney, Australia
⁷Paediatric Epidemiology Group, University of Leeds, Leeds, U.K.
⁸Centre for Occupational and Health Psychology, Cardiff University, Cardiff, U.K.
⁹Department of Public Health and Epidemiology, Riga Stradins University, Riga, Latvia
¹⁰Institute of Endocrinology, Kaunas University of Medicine, Kaunas, Lithuania
¹¹Department of Paediatrics, Medical University of Vienna, Vienna, Austria
¹²Department of Social Sciences and Communication, University of Lecce, Lecce, Italy
¹³Nutrition and Metabolic Diseases Clinic, N. Paulescu Institute of Diabetes, Bucharest, Romania
¹⁴Clinique Pédiatrique Luxembourg, Luxembourg, Luxembourg
¹⁵Department of Pediatrics, University of Pécs, Pécs, Hungary

Corresponding author: Chris R. Cardwell, c.cardwell{at}qub.ac.uk.

Diabetes 2012 Mar; 61(3): 702-707. https://doi.org/10.2337/db11-1000

Abstract

Short interbirth interval has been associated with maternal complications and childhood autism and leukemia, possibly due to deficiencies in maternal micronutrients at conception or increased exposure to sibling infections. A possible association between interbirth interval and subsequent risk of childhood type 1 diabetes has not been investigated. A secondary analysis of 14 published observational studies of perinatal risk factors for type 1 diabetes was conducted. Risk estimates of diabetes by category of interbirth interval were calculated for each study. Random effects models were used to calculate pooled odds ratios (ORs) and investigate heterogeneity between studies. Overall, 2,787 children with type 1 diabetes were included. There was a reduction in the risk of childhood type 1 diabetes in children born to mothers after interbirth intervals <3 years compared with longer interbirth intervals (OR 0.82 [95% CI 0.72–0.93]). Adjustments for various potential confounders little altered this estimate. In conclusion, there was evidence of a 20% reduction in the risk of childhood diabetes in children born to mothers after interbirth intervals <3 years.

Received July 18, 2011.
Accepted December 9, 2011.

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