The Association of Birth Weight and Early Childhood Weight Trajectories with the incidence of Type II Diabetes.

Abstract

Background: Perinatal factors, including gestational age, birthweight, size-for-gestational age, delivery route, maternal parity, maternal age, and socioeconomic status, have been linked to the long-term incidence of chronic comorbidities. We evaluated the association of birth size characteristics and early childhood growth trajectories with Type II diabetes (DM2) in adolescence and adulthood. Methods: We conducted a population-based, nested case-control study in a birth cohort of infants born to residents of Olmsted County, MN between 1976-1982, using the resources of the Rochester Epidemiology Project. Cases with DM2 first diagnosed after age 10 and prior to October 2020 were identified using diagnosis codes and confirmed via chart review. For each case, we randomly selected two age-and sex-matched controls from the birth cohort. Using birth certificate data, we obtained mothers' age and education level and infant sex, race, type of delivery, single/multiple birth, gestational age, and birthweight . Individual-level socioeconomic status (SES) of the household at birth was determined with the HOUSES index. Weight and height data from birth through age 66 months was abstracted from the medical records and sex-specific weight-for-age percentiles were obtained from the 2000 CDC growth charts. A nonparametric hill-climbing algorithm was used to identify distinct homogeneous clusters of weight-for-age trajectories among all cases and controls combined. Univariate conditional logistic regression models were fit to assess associations. Results: Among the 123 DM2 cases, the mean age at diagnosis 34.2 (SD, 4.9) years and 59.3% were male. None of the socioeconomic characteristics nor the type of delivery were significantly associated with DM2 case status. The odds of being a late term vs a term delivery were significantly greater for DM2 cases compared to matched controls (OR 2.09; 95%CI 1.14-3.84). The odds of being large-for-gestational-age versus average were significantly lower for DM2 cases compared to matched controls (OR 0.51; 95%CI 0.29-1.89) and the mean birthweight was significantly lower for DM2 cases compared to controls (mean [SD], 3379 [642]g vs. 3583 [540]g, p=0.002). Conclusion: Low birth weight, large for gestational age and a late term pregnancy were associated with DM2 after age 10 years compared with age- and sex-matched controls from the same birth cohort. Weight gain trajectories through 66 months of age were not associated with DM2.