Article (Scientific journals)
Breast-feeding and childhood-onset type 1 diabetes: a pooled analysis of individual participant data from 43 observational studies
Cardwell, C.R.; Stene, L.C.; Ludvigsson, J. et al.
2012In Diabetes Care, 35 (11), p. 2215-2225
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Keywords :
breast-feeding; childhood; type 1 diabetes; observational studies
Abstract :
[en] OBJECTIVE To investigate if there is a reduced risk of type 1 diabetes in children breastfed or exclusively breastfed by performing a pooled analysis with adjustment for recognized confounders. RESEARCH DESIGN AND METHODS Relevant studies were identified from literature searches using MEDLINE, Web of Science, and EMBASE. Authors of relevant studies were asked to provide individual participant data or conduct prespecified analyses. Meta-analysis techniques were used to combine odds ratios (ORs) and investigate heterogeneity between studies. RESULTS Data were available from 43 studies including 9,874 patients with type 1 diabetes. Overall, there was a reduction in the risk of diabetes after exclusive breast-feeding for >2 weeks (20 studies; OR = 0.75, 95% CI 0.64–0.88), the association after exclusive breast-feeding for >3 months was weaker (30 studies; OR = 0.87, 95% CI 0.75–1.00), and no association was observed after (nonexclusive) breast-feeding for >2 weeks (28 studies; OR = 0.93, 95% CI 0.81–1.07) or >3 months (29 studies; OR = 0.88, 95% CI 0.78–1.00). These associations were all subject to marked heterogeneity (I2 = 58, 76, 54, and 68%, respectively). In studies with lower risk of bias, the reduced risk after exclusive breast-feeding for >2 weeks remained (12 studies; OR = 0.86, 95% CI 0.75–0.99), and heterogeneity was reduced (I2 = 0%). Adjustments for potential confounders altered these estimates very little. CONCLUSIONS The pooled analysis suggests weak protective associations between exclusive breast-feeding and type 1 diabetes risk. However, these findings are difficult to interpret because of the marked variation in effect and possible biases (particularly recall bias) inherent in the included studies.
Disciplines :
Human health sciences: Multidisciplinary, general & others
Author, co-author :
Cardwell, C.R.
Stene, L.C.
Ludvigsson, J.
Rosenbauer, J.
Cinek, O.
Svensson, J.
Perez-Bravo, F.
Memon, A.
Gimeno, S.G.
Wadsworth, E.J.
Strotmeyer, E.S.
Goldacre, M.J.
Radon, K.
Chuang, L.M.
Parslow, R.C.
Chetwynd, A.
Karavanaki, K.
Brigis, G.
Pozzilli, P.
Urbonaite, B.
Schober, E.
Devoti, G.
Sipetic, S.
Joner, G.
Ionescu-Tirgoviste, C.
De Beaufort, Carine ;  University of Luxembourg > Luxembourg Centre for Systems Biomedicine (LCSB)
Harrild, K.
Benson, V.
Savilahti, E.
Ponsonby, A.L.
Salem, M.
Rabiei, S.
Patterson, C.C.
More authors (23 more) Less
External co-authors :
yes
Language :
English
Title :
Breast-feeding and childhood-onset type 1 diabetes: a pooled analysis of individual participant data from 43 observational studies
Publication date :
November 2012
Journal title :
Diabetes Care
ISSN :
1935-5548
Publisher :
American Diabetes Association, Alexandria, United States - Virginia
Volume :
35
Issue :
11
Pages :
2215-2225
Peer reviewed :
Peer Reviewed verified by ORBi
Available on ORBilu :
since 30 April 2016

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