Pre-pregnancy body mass index in mothers, birth weight and the risk of type I diabetes in their offspring: A dose-response meta-analysis of cohort studies - 17/01/21

Doi : 10.1016/j.jogoh.2020.101921

Haiyan Wang ^a, Zhongmin Zhang ^b, Yanfang Liu ^a, Jiaqi Yang ^c, Jinhuan Zhang ^a, Cain Clark ^d, David Avelar Rodriguez ^e, Palanisamy Amirthalingam ^f, Yanwei Guo ^a,^⁎
^a Obstetrics Department, Affiliated Hospital of Chengde Medical College, Chengde City, 067100, China
^b Clinical Laboratory, Staff Hospital of Chengde Iron & Steel Group Co., LTD., Chengde City, 067102, China
^c Department of Preventive Medicine, Chengde Medical College, Chengde City, 067100, China
^d Centre for Sport, Exercise and Life Sciences, Coventry University, Coventry, CV1 5FB, United Kingdom
^e Pediatric Gastroenterology and Nutrition Unit, Instituto Nacional De Pediatria, Coyoacan, Mexico
^f Department of Pharmacy Practice, Faculty of Pharmacy, University of Tabuk, P.O. Box 741, Tabuk 71491, Saudi Arabia

^⁎Corresponding author.

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Abstract

Background

The incidence of type I diabetes among children has increased significantly and the relationship between maternal pre-pregnancy Body Mass Index (BMI), Birth weight and risk of Type 1 diabetes in children (T1DMC) is controversial.

Objective

This dose-response meta-analysis was performed to investigate the association between maternal Pre-Pregnancy Body-Mass Index, Birth Weight and the Risk of Childhood Type I Diabetes.

Search strategy

A comprehensive systematic search was conducted in MEDLINE/PubMed, SCOPUS, Cochrane, and Web of Science databases from inception to April 2019. Key search terms included “body mass index” OR “Birth weight” AND “Type 1 diabetes”.

Selection criteria

Peer-reviewed studies that reporting association between BMI or birth weight and type I diabetes in a retrospective or prospective study by appropriate estimates such as the hazard ratio (HR), risk ratio (RR), or odds ratio (OR) and the corresponding 95 % confidence intervals (CI).

Data collection and analysis

MOOSE guidelines were followed. Data were extracted by 2 researchers, independently. Combined hazard ratios (HRs) was evaluated by DerSimonian and Laird Random-effects model.

Results

Two studies continuing four arms with 1,209,122 participants were eligible for pre-pregnancy BMI section meta-analysis and six studies were eligible for inclusion, providing 10,340,036 participants for birth weight section meta-analysis. Pooled results demonstrated a significant association between obesity and risk of T1DMC (HR: 1.30, 95 % CI: 1.16–1.46, I2 = 7%). The combined HR (95 % CI) showed lower risk of T1DMC in low birth weight infants (HR: 0.78, 95 % CI: 0.69−0.88, I2 = 0%) and higher risk of T1DMC in the high birth weight infants versus the normal category of birth weight (HR: 1.08, 95 % CI: 1.00–1.17, I2 = 31 %). There was a significant non-linear association between birth weight and risk of T1DMC in children (Coef =-0.00032, p = 0.001).