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Birth order and childhood type 1 diabetes risk: a pooled analysis of 31 observational studies

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Birth order and childhood type 1 diabetes risk: a pooled analysis of 31 observational studies. / Cardwell, Chris R.; Stene, Lars C.; Joner, Geir et al.
In: International Journal of Epidemiology, Vol. 40, No. 2, 04.2011, p. 363-374.

Research output: Contribution to Journal/Magazine › Journal article › peer-review

Harvard

Cardwell, CR, Stene, LC, Joner, G, Bulsara, MK, Cinek, O, Rosenbauer, J, Ludvigsson, J, Svensson, J, Goldacre, MJ, Waldhoer, T, Jarosz-Chobot, P, Gimeno, SGA, Chuang, L-M, Roberts, CL, Parslow, RC, Wadsworth, EJK, Chetwynd, A, Brigis, G, Urbonaite, B, Sipetic, S, Schober, E, Devoti, G, Ionescu-Tirgoviste, C, de Beaufort, CE, Stoyanov, D, Buschard, K, Radon, K, Glatthaar, C & Patterson, CC 2011, 'Birth order and childhood type 1 diabetes risk: a pooled analysis of 31 observational studies', International Journal of Epidemiology, vol. 40, no. 2, pp. 363-374. https://doi.org/10.1093/ije/dyq207

APA

Cardwell, C. R., Stene, L. C., Joner, G., Bulsara, M. K., Cinek, O., Rosenbauer, J., Ludvigsson, J., Svensson, J., Goldacre, M. J., Waldhoer, T., Jarosz-Chobot, P., Gimeno, S. G. A., Chuang, L-M., Roberts, C. L., Parslow, R. C., Wadsworth, E. J. K., Chetwynd, A., Brigis, G., Urbonaite, B., ... Patterson, C. C. (2011). Birth order and childhood type 1 diabetes risk: a pooled analysis of 31 observational studies. International Journal of Epidemiology, 40(2), 363-374. https://doi.org/10.1093/ije/dyq207

Vancouver

Cardwell CR, Stene LC, Joner G, Bulsara MK, Cinek O, Rosenbauer J et al. Birth order and childhood type 1 diabetes risk: a pooled analysis of 31 observational studies. International Journal of Epidemiology. 2011 Apr;40(2):363-374. doi: 10.1093/ije/dyq207

Author

Cardwell, Chris R. ; Stene, Lars C. ; Joner, Geir et al. / Birth order and childhood type 1 diabetes risk : a pooled analysis of 31 observational studies. In: International Journal of Epidemiology. 2011 ; Vol. 40, No. 2. pp. 363-374.

Bibtex

@article{3f03e1bea0374ed3b50a117bcfb98697,
title = "Birth order and childhood type 1 diabetes risk: a pooled analysis of 31 observational studies",
abstract = "Background The incidence rates of childhood onset type 1 diabetes are almost universally increasing across the globe but the aetiology of the disease remains largely unknown. We investigated whether birth order is associated with the risk of childhood diabetes by performing a pooled analysis of previous studies.Methods Relevant studies published before January 2010 were identified from MEDLINE, Web of Science and EMBASE. Authors of studies provided individual patient data or conducted pre-specified analyses. Meta-analysis techniques were used to derive combined odds ratios (ORs), before and after adjustment for confounders, and investigate heterogeneity.Results Data were available for 6 cohort and 25 case-control studies, including 11 955 cases of type 1 diabetes. Overall, there was no evidence of an association prior to adjustment for confounders. After adjustment for maternal age at birth and other confounders, a reduction in the risk of diabetes in second- or later born children became apparent [fully adjusted OR = 0.90 95% confidence interval (CI) 0.83-0.98; P = 0.02] but this association varied markedly between studies (I-2 = 67%). An a priori subgroup analysis showed that the association was stronger and more consistent in children < 5 years of age (n = 25 studies, maternal age adjusted OR = 0.84 95% CI 0.75, 0.93; I-2 = 23%).Conclusion Although the association varied between studies, there was some evidence of a lower risk of childhood onset type 1 diabetes with increasing birth order, particularly in children aged < 5 years. This finding could reflect increased exposure to infections in early life in later born children.",
keywords = "Diabetes mellitus, type 1, epidemiology, birth order, meta-analysis, MATERNAL AGE, EARLY-LIFE, MELLITUS, CHILDREN, DETERMINANTS, ONSET, IDDM, INFECTIONS, DELIVERY, UK",
author = "Cardwell, {Chris R.} and Stene, {Lars C.} and Geir Joner and Bulsara, {Max K.} and Ondrej Cinek and Joachim Rosenbauer and Johnny Ludvigsson and Jannet Svensson and Goldacre, {Michael J.} and Thomas Waldhoer and Przemyslawa Jarosz-Chobot and Gimeno, {Suely G. A.} and Lee-Ming Chuang and Roberts, {Christine L.} and Parslow, {Roger C.} and Wadsworth, {Emma J. K.} and Amanda Chetwynd and Girts Brigis and Brone Urbonaite and Sandra Sipetic and Edith Schober and Gabriele Devoti and Constantin Ionescu-Tirgoviste and {de Beaufort}, {Carine E.} and Denka Stoyanov and Karsten Buschard and Katja Radon and Christopher Glatthaar and Patterson, {Chris C.}",
year = "2011",
month = apr,
doi = "10.1093/ije/dyq207",
language = "English",
volume = "40",
pages = "363--374",
journal = "International Journal of Epidemiology",
publisher = "NLM (Medline)",
number = "2",

}

RIS

TY - JOUR

T1 - Birth order and childhood type 1 diabetes risk

T2 - a pooled analysis of 31 observational studies

AU - Cardwell, Chris R.

AU - Stene, Lars C.

AU - Joner, Geir

AU - Bulsara, Max K.

AU - Cinek, Ondrej

AU - Rosenbauer, Joachim

AU - Ludvigsson, Johnny

AU - Svensson, Jannet

AU - Goldacre, Michael J.

AU - Waldhoer, Thomas

AU - Jarosz-Chobot, Przemyslawa

AU - Gimeno, Suely G. A.

AU - Chuang, Lee-Ming

AU - Roberts, Christine L.

AU - Parslow, Roger C.

AU - Wadsworth, Emma J. K.

AU - Chetwynd, Amanda

AU - Brigis, Girts

AU - Urbonaite, Brone

AU - Sipetic, Sandra

AU - Schober, Edith

AU - Devoti, Gabriele

AU - Ionescu-Tirgoviste, Constantin

AU - de Beaufort, Carine E.

AU - Stoyanov, Denka

AU - Buschard, Karsten

AU - Radon, Katja

AU - Glatthaar, Christopher

AU - Patterson, Chris C.

PY - 2011/4

Y1 - 2011/4

N2 - Background The incidence rates of childhood onset type 1 diabetes are almost universally increasing across the globe but the aetiology of the disease remains largely unknown. We investigated whether birth order is associated with the risk of childhood diabetes by performing a pooled analysis of previous studies.Methods Relevant studies published before January 2010 were identified from MEDLINE, Web of Science and EMBASE. Authors of studies provided individual patient data or conducted pre-specified analyses. Meta-analysis techniques were used to derive combined odds ratios (ORs), before and after adjustment for confounders, and investigate heterogeneity.Results Data were available for 6 cohort and 25 case-control studies, including 11 955 cases of type 1 diabetes. Overall, there was no evidence of an association prior to adjustment for confounders. After adjustment for maternal age at birth and other confounders, a reduction in the risk of diabetes in second- or later born children became apparent [fully adjusted OR = 0.90 95% confidence interval (CI) 0.83-0.98; P = 0.02] but this association varied markedly between studies (I-2 = 67%). An a priori subgroup analysis showed that the association was stronger and more consistent in children < 5 years of age (n = 25 studies, maternal age adjusted OR = 0.84 95% CI 0.75, 0.93; I-2 = 23%).Conclusion Although the association varied between studies, there was some evidence of a lower risk of childhood onset type 1 diabetes with increasing birth order, particularly in children aged < 5 years. This finding could reflect increased exposure to infections in early life in later born children.

AB - Background The incidence rates of childhood onset type 1 diabetes are almost universally increasing across the globe but the aetiology of the disease remains largely unknown. We investigated whether birth order is associated with the risk of childhood diabetes by performing a pooled analysis of previous studies.Methods Relevant studies published before January 2010 were identified from MEDLINE, Web of Science and EMBASE. Authors of studies provided individual patient data or conducted pre-specified analyses. Meta-analysis techniques were used to derive combined odds ratios (ORs), before and after adjustment for confounders, and investigate heterogeneity.Results Data were available for 6 cohort and 25 case-control studies, including 11 955 cases of type 1 diabetes. Overall, there was no evidence of an association prior to adjustment for confounders. After adjustment for maternal age at birth and other confounders, a reduction in the risk of diabetes in second- or later born children became apparent [fully adjusted OR = 0.90 95% confidence interval (CI) 0.83-0.98; P = 0.02] but this association varied markedly between studies (I-2 = 67%). An a priori subgroup analysis showed that the association was stronger and more consistent in children < 5 years of age (n = 25 studies, maternal age adjusted OR = 0.84 95% CI 0.75, 0.93; I-2 = 23%).Conclusion Although the association varied between studies, there was some evidence of a lower risk of childhood onset type 1 diabetes with increasing birth order, particularly in children aged < 5 years. This finding could reflect increased exposure to infections in early life in later born children.

KW - Diabetes mellitus

KW - type 1

KW - epidemiology

KW - birth order

KW - meta-analysis

KW - MATERNAL AGE

KW - EARLY-LIFE

KW - MELLITUS

KW - CHILDREN

KW - DETERMINANTS

KW - ONSET

KW - IDDM

KW - INFECTIONS

KW - DELIVERY

KW - UK

U2 - 10.1093/ije/dyq207

DO - 10.1093/ije/dyq207

M3 - Journal article

VL - 40

SP - 363

EP - 374

JO - International Journal of Epidemiology

JF - International Journal of Epidemiology

IS - 2

ER -