Journal
INTERNATIONAL JOURNAL OF EPIDEMIOLOGY
Volume 47, Issue 5, Pages 1538-1548Publisher
OXFORD UNIV PRESS
DOI: 10.1093/ije/dyy092
Keywords
Antibiotics; acetaminophen; paracetamol; infection; type 1 diabetes; pregnancy; childhood; Norwegian Mother and Child Cohort
Categories
Funding
- Oak Foundation, Geneva, Switzerland
- Norwegian Research Council [2210909/F20]
- European Research Council
- K. G. Jebsen Foundation
- Research Council of Norway
- Norwegian Ministry of Health and Care Services
- Ministry of Education and Research, NIH/NIEHS [N01-ES-75558]
- Ministry of Education and Research, NIH/NINDS [1 UO1 NS 047537-01, 2 UO1 NS 047537-06A1]
- South-Eastern Norway Regional Health Authority
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Background: Infections in early life have been linked to type 1 diabetes (T1D) risk, but no previous study has comprehensively analysed exposure to antibiotics, acetaminophen and infections during pregnancy and early childhood in relation to offspring risk of T1D. Methods: Participants in the Norwegian Mother and Child Cohort Study (n = 114 215 children, of whom 403 children were diagnosed with T1D) reported infections and medication use through repeated questionnaires from pregnancy until the children were 18 months old. Adjusted hazard ratios (aHR) for offspring T1D were estimated through Cox regression adjusted for child's sex, maternal age and parity, maternal T1D, smoking in pregnancy, education level, pre-pregnancy body mass index (BMI) and birthweight. Antibiotic use was also analysed in a population-based register cohort of 541 036 children of whom 836 developed T1D. Results: Hospitalization for gastroenteritis during the first 18 months of life was associated with increased risk (aHR 2.27, 95% CI 1.21 - 4.29, P = 0.01) of T1D. Childhood infections not requiring hospitalization, or any kind of maternal infection during pregnancy, did not predict offspring risk of T1D. Antibiotic or acetaminophen use in pregnancy, or childs use in early childhood, was not associated with risk of T1D. Conclusions: Our study, which is population-based and the largest of its kind, did not find support for general early life infections, infection frequency or use of antibiotics or acetaminophen to play a major role in childhood T1D. Hospital admission for gastroenteritis was associated with T1D risk, but must be interpreted cautiously due to scarcity of cases.
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