Pre-natal and early life risk factors for childhood onset diabetes mellitus: a record linkage study.

Abstract

Using data from the Oxford Record Linkage Study (ORLS) we conducted a case-control study to examine pre-natal and early life risk factors for childhood and adolescent onset diabetes mellitus. We identified 160 boys and 155 girls born 1965-1986 and admitted to hospital with a diagnosis of diabetes during 1965-1987 in the ORLS area. Up to eight controls were matched to each case on sex, year of birth and hospital or place of birth. We linked the hospital records for each child to all of that child's hospital records and to his or her mother's maternity record. There were no significant associations between subsequent diabetes and birthweight, gestational age, birthweight for gestational age, maternal age and parity. There were increased risks with not breastfeeding (relative risk [RR] = 1.33; 95% CI: 0.76-2.34), and with diabetes recorded in the mother during pregnancy (RR = 5.87; 95% CI : 0.90-38.3), but these were not statistically significant. There was a significantly raised risk with pre-eclampsia or eclampsia during pregnancy (RR = 1.48; 95% CI: 1.05-2.10). Pre-eclampsia may be the result of an immunogenetic incompatibility between mother and fetus, and this early immunological disturbance might be related to incidence of diabetes in later life.