Reference : Birth order and childhood type 1 diabetes risk: A pooled analysis of 31 observational...
Scientific journals : Article
Human health sciences : Multidisciplinary, general & others
Birth order and childhood type 1 diabetes risk: A pooled analysis of 31 observational studies
Cardwell, C. R. [Centre for Public Health, Queen's University Belfast, Belfast, United Kingdom]
Stene, L. C. [Division of Epidemiology, Norwegian Institute of Public Health, Oslo, Norway, Oslo Diabetes Research Centre, Oslo University Hospital, Oslo, Norway]
Joner, G. [Institute of Health Management and Health Economics, University of Oslo, Oslo, Norway]
Bulsara, M. K. [Telethon Institute for Child Health Research, Centre for Child Health Research, University of Western Australia, Perth, Australia, Institute of Health and Rehabilitation Research, University of Notre Dame, Freemantle, Australia]
Cinek, O. [The 2nd Medical School, Charles University, Prague, Czech Republic]
Rosenbauer, J. [Institute of Biometrics and Epidemiology, German Diabetes Centre, Leibniz Institute at Dusseldorf University, Dusseldorf, Germany]
Ludvigsson, J. [Department of Paediatrics and Diabetes Research Centre, Linkoping University, Linkoping, Sweden]
Svensson, J. [Pediatric Department, Glostrup University Hospital, Glostrup, Denmark]
Goldacre, M. J. [Department of Public Health, Oxford University, Oxford, United Kingdom]
Waldhoer, T. [Department of Epidemiology, Medical University of Vienna, Vienna, Austria]
Jarosz-Chobot, P. [Department of Pediatric Endocrinology and Diabetes, Medical University of Silesia, Katowice, Poland]
Gimeno, S. G. [Preventive Medicine Department, Federal University of Sao Paulo, Sao Paulo, Brazil]
Chuang, L.-M. [Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan]
Roberts, C. L. [Kolling Institute of Medical Research, University of Sydney, Sydney, Australia]
Parslow, R. C. [Paediatric Epidemiology Group, University of Leeds, Leeds, United Kingdom]
Wadsworth, E. J. [Centre for Occupational and Health Psychology, Cardiff University, Cardiff, United Kingdom]
Chetwynd, A. [Mathematics and Statistics Department, Lancaster University, Lancaster, United Kingdom]
Brigis, G. [Department of Public Health and Epidemiology, Riga Stradins University, Riga, Latvia]
Urbonaite, B. [Institute of Endocrinology, Kaunas University of Medicine, Kaunas, Lithuania]
Šipetić, S. [Institute of Epidemiology, School of Medicine, Belgrade University, Belgrade, Serbia]
Schober, E. [Department of Paediatrics, Medical University of Vienna, Vienna, Austria]
Devoti, G. [Department of Social Sciences and Communication, University of Lecce, Lecce, Italy]
Ionescu-Tirgoviste, C. [Nutrition and Metabolic Diseases Clinic, N. Paulescu Institute of Diabetes, Bucharest, Romania]
De Beaufort, Carine mailto [University of Luxembourg > Luxembourg Centre for Systems Biomedicine (LCSB) >]
Stoyanov, D. [Children's Diabetic Centre, Sofia, Bulgaria]
Buschard, K. [Bartholin Instituttet, Rigshospitalet, Copenhagen, Denmark]
Radon, K. [Institute and Outpatient Clinic for Occupational and Environmental Medicine, Hospital of the LMU Munich, Munich, Germany]
Glatthaar, C. [Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Perth, Australia]
Patterson, C. C. [Centre for Public Health, Queen's University Belfast, Belfast, United Kingdom]
International Journal of Epidemiology
Yes (verified by ORBilu)
[en] Birth order ; Diabetes mellitus ; Epidemiology ; Meta-analysis ; Type 1 ; Birth Order ; Case-Control Studies ; Child, Preschool ; Diabetes Mellitus, Type 1 ; Female ; Humans ; Maternal Age ; Odds Ratio
[en] 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 (I2=67%). An a priori subgroup analysis showed that the association was stronger and more consistent in children <5years of age (n=25 studies, maternal age adjusted OR=0.84 95% CI 0.75, 0.93; I2=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. Published by Oxford University Press on behalf of the International Epidemiological Association © The Author 2010; all rights reserved.

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