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Perinatal risk factors for childhood Type 1 diabetes in Western Australia—a population-based study (1980–2002)

Authors


Dr Elizabeth A. Davis, Department of Endocrinology & Diabetes, Princess Margaret Hospital, GPO Box D184, Perth, Western Australia 6008. E-mail: elizabeth.davis@health.wa.gov.au

Abstract

Aims  To investigate perinatal risk factors for childhood Type 1 diabetes in Western Australia, using a complete population-based cohort.

Methods  Children born between 1980 and 2002 and diagnosed with Type 1 diabetes aged < 15 years (n = 940) up to 31 December 2003 were identified using a prospective population-based diabetes register with a case ascertainment rate of 99.8%. Perinatal data were obtained for all live births in Western Australia from 1980 to 2002 (n = 558 633) and record linkage performed to identify the records of cases.

Results  The incidence of Type 1 diabetes increased by 13% for each 5-year increase in maternal age [adjusted incidence rate ratio (IRR) 1.13, 95% confidence interval (CI) 1.05, 1.21], by 13% for every 500-g increase in birth weight (adjusted IRR 1.13, 95% CI 1.04, 1.23). The incidence decreased with increasing birth order (adjusted IRR 0.89, 95% CI 0.82, 0.96) and increasing gestational age (adjusted IRR 0.84, 95% CI 0.77, 0.93). A higher incidence of Type 1 diabetes was associated with an urban vs. non-urban maternal address at the time of birth (adjusted IRR 1.38, 95% CI 1.18, 1.63), but no association was found with socio-economic status of the area.

Conclusions  A higher incidence of Type 1 diabetes was associated with increasing maternal age, higher birth weight, lower gestational age, lower birth order and urban place of residence at the time of birth.

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