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母源性和新生儿源性儿童 1 型糖尿病风险因素:一项匹配病例对照研究。

Maternal and neonatal risk factors for childhood type 1 diabetes: a matched case-control study.

机构信息

NHS Grampian, Summerfield House, Aberdeen, UK.

出版信息

BMC Public Health. 2010 May 27;10:281. doi: 10.1186/1471-2458-10-281.

Abstract

BACKGROUND

An interaction between genetic susceptibility and environmental factors is thought to be involved in the aetiology of type 1 diabetes. The aim of this study was to investigate maternal and neonatal risk factors for type 1 diabetes in children under 15 years old in Grampian, Scotland.

METHODS

A matched case-control study was conducted by record linkage. Cases (n = 361) were children born in Aberdeen Maternity Hospital from 1972 to 2002, inclusive, who developed type 1 diabetes, identified from the Scottish Study Group for the Care of Diabetes in the Young Register. Controls (n = 1083) were randomly selected from the Aberdeen Maternity Neonatal Databank, matched by year of birth. Exposure data were obtained from the Aberdeen Maternity Neonatal Databank. Conditional logistic regression was used to evaluate the association between various maternal and neonatal factors and the risk of type 1 diabetes.

RESULTS

There was no evidence of statistically significant associations between type 1 diabetes and maternal age, maternal body mass index, previous abortions, pre-eclampsia, amniocentesis, maternal deprivation, use of syntocinon, mode of delivery, antepartum haemorrhage, baby's sex, gestational age at birth, birth order, birth weight, jaundice, phototherapy, breast feeding, admission to neonatal unit and Apgar score (P > 0.05). A significantly decreased risk of type 1 diabetes was observed in children whose mothers smoked at the booking appointment compared to those whose mothers did not, with an adjusted OR of 0.67, 95% CI (0.46, 0.99).

CONCLUSIONS

This case-control study found limited evidence of a reduced risk of the development of type 1 diabetes in children whose mothers smoked, compared to children whose mothers did not. No evidence was found of a significant association between other maternal and neonatal factors and childhood type 1 diabetes.

摘要

背景

遗传易感性和环境因素之间的相互作用被认为与 1 型糖尿病的发病机制有关。本研究的目的是调查苏格兰格兰扁地区 15 岁以下儿童 1 型糖尿病的母婴危险因素。

方法

通过记录链接进行了匹配病例对照研究。病例(n=361)是 1972 年至 2002 年期间在阿伯丁妇产医院出生的儿童,这些儿童在苏格兰年轻糖尿病护理研究组登记册中确诊为 1 型糖尿病。对照组(n=1083)是从阿伯丁妇产新生儿数据库中随机选择的,按出生年份匹配。暴露数据来自阿伯丁妇产新生儿数据库。使用条件逻辑回归评估各种母婴因素与 1 型糖尿病风险之间的关联。

结果

1 型糖尿病与母亲年龄、母亲体重指数、既往流产、子痫前期、羊膜穿刺术、母婴剥夺、使用缩宫素、分娩方式、产前出血、婴儿性别、出生时胎龄、出生顺序、出生体重、黄疸、光疗、母乳喂养、新生儿病房入院和阿普加评分之间没有统计学上显著的关联(P>0.05)。与母亲不吸烟的儿童相比,在预约时吸烟的母亲的儿童患 1 型糖尿病的风险显著降低,调整后的 OR 为 0.67,95%CI(0.46,0.99)。

结论

本病例对照研究发现,与母亲不吸烟的儿童相比,母亲吸烟的儿童患 1 型糖尿病的风险降低,但证据有限。没有发现其他母婴因素与儿童 1 型糖尿病之间存在显著关联。

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