Abstract
BackgroundTo assess the risk of developing Type-1 diabetes among children who were exposed to maternal bereavement during the prenatal or 1-year preconception period.MethodsWe identified N = 1,548,746 singleton births born in Denmark between January 1st 1979 through December 31st 2004, and their next of kin. Altogether, 39,857 children were exposed to bereavement during their prenatal life. The main outcome of interest was hospitalization for type-1 diabetes (ICD 8: 249; ICD 10: E10).ResultsWe found the strongest association for type-1 diabetes among children exposed to traumatic father or sibling deaths (aIRR: 2.03, 1.22–3.38); the association was mainly seen for girls (aIRR: 2.91, 1.61–5.26).ConclusionsWe found evidence to suggest that female fetuses exposed to severe prenatal stress are at increased risk for developing type-1 diabetes.
Highlights
Diabetes is one of the most common chronic diseases among children; the increase in frequency of type-1 diabetes in youth has been among the most concerning aspects of the evolving epidemic
A recent analysis conducted in 17 European countries suggests that cases of type-1 diabetes in children will double between 2005 and 2020, and that prevalent cases younger than 15 years will increase by 70%
We looked for additional cases from the Pharmaco-epidemiological Prescription Database, in operation since 1995, using the ATC codes for insulin analog drugs (A10A), though there was almost 100% overlap with these cases and those found in the hospital register
Summary
Diabetes is one of the most common chronic diseases among children; the increase in frequency of type-1 diabetes in youth has been among the most concerning aspects of the evolving epidemic. The role of inflammation in insulitis as a biological response to infection and b-cell loss has been studied in animal models This process is not clearly understood but it must be induced early in life, where some combination of genetic and environmental factors operate to activate both endogenous and exogenous ligands of patternrecognition receptors that induce islet inflammation and death of pancreatic b-cells. This is followed by a second process where insulitis is amplified through interplay between immune cells and b-cells, and third process where inflammatory mediators contribute to prolonged suppression and death of b-cells, or promotion, survival and proliferation of b cells [4]. To assess the risk of developing Type-1 diabetes among children who were exposed to maternal bereavement during the prenatal or 1-year preconception period
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