Influence of maternal age at delivery and birth order on risk of type 1 diabetes in childhood: prospective population based family study
Influence of maternal age at delivery and birth order on risk of type 1 diabetes in childhood: prospective population based family study
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DOI：
10.1136/bmj.321.7258.420
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发表时间：
2000-08-12
影响因子：
105.7
通讯作者：
Gale, EAM
中科院分区：
文献类型：
--
作者：
Bingley, PJ;Douek, IF;Gale, EAM
目的 研究父母分娩年龄的影响；设计基于预期人口的家庭研究设置区域以前由牛津地区卫生局管理。参与者 1375 个家庭，其中一名或多名儿童患有糖尿病。在 3221 名后代中，1431 名患有糖尿病（诊断时的中位年龄为 10.5 岁，范围为 0.5-28.5 岁），1790 名在中位年龄为 16.1 岁时仍未患糖尿病。主要结果指标通过 Cox 比例风险回归评估所有后代的无病生存率和发生 1 型糖尿病的风险比。结果 母亲分娩时的年龄与 1 型糖尿病的风险密切相关。对于后代，母亲年龄每 5 岁范围，风险增加 25%（95% 置信区间 17% 至 34%），因此，与 20 岁以下的母亲相比，45 岁或以上的母亲分娩时的相对风险为 3.11（2.07 至 4.66）。父亲年龄每增加 5 岁，父亲年龄也会增加 9%（3% 至 16%）。根据父母分娩年龄和后代性别进行调整后，患糖尿病的相对风险随着出生顺序的增加而降低；总体效果是，每个孩子出生的风险降低了 15%（10% 至 21%） 结论 研究发现，母亲分娩年龄的增加与孩子患糖尿病的风险之间存在密切关联。长子的风险最高，并且随着出生顺序的增加而逐渐降低。胎儿环境似乎对儿童患 trpe I 型糖尿病的风险有很大影响。过去二十年来，英国产妇分娩年龄的增加可能部分解释了这一时期儿童糖尿病发病率的增加。
Objectives To examine the influence of parental age at delivery; and birth order on subsequent risk of childhood diabetes.Design Prospective population based family studySetting Area formerly administered by the Oxford Regional Health Authority.Participants 1375 families in which one child or more had diabetes. Of 3221 offspring, 1431 had diabetes (median age at diagnosis 10.5 years, range 0.5-28.5) and 1790 remained non-diabetic at a median age of 16.1 years.Main outcome measures Disease free survival and hazard ratios for the development of type 1 diabetes in all offspring, assessed by Cox proportional hazard regression.Results Maternal age at delivery was strongly related to risk of type 1 diabetes in the offspring, risk increased by 25% (95% confidence interval 17% to 34%) for each five year band of maternal age, so that maternal age at delivery of 45 years or more was associated with a relative risk of 3.11 (2.07 to 4.66) compared with a maternal age of less than 20 years. Paternal age was also associated with a 9% (3% to 16%) increase for each five year increase in paternal age. The relative risk of diabetes, adjusted for parental age at delivery and sex of offspring, decreased with increasing birth order; the overall effect was a 15% risk reduction (10% to 21%) per child bornConclusions A strong association was found between increasing maternal age at delivery and risk of diabetes in the child. Risk was highest in firstborn children and decreased progressively with higher birth order. The fetal environment seems to have a strong influence on risk of trpe I diabetes in the child. The increase in maternal age at delivery in the United Kingdom over the past two decades could partly account for the increase in incidence of childhood diabetes over this period.