title: Perinatal and childhood risk factors for early-onset type 1 diabetes: a population-based case-control study in Taiwan.
abstract: BACKGROUND
  Certain factors originating from the perinatal and childhood periods are suspected of contributing to the recent increasing trend of childhood type 1 diabetes (T1D) incidence. This study sought to investigate the relationships between various perinatal and childhood risk factors and T1D incidence in young children (<10 years).
  
  
  METHODS
  We used a nested case-control design based on 1,478,573 live births born in 2000-05 in Taiwan. Cases were 632 incident cases of T1D between 2000 and 2008. Ten matched controls for each case were randomly selected. Information on various perinatal risk factors was also identified from claim data. Multiple conditional logistic regression was employed to estimate odds ratio (OR) and 95 confidence interval (CI) of T1D.
  
  
  RESULTS
  Childhood infection was significantly associated with an increased risk of T1D (OR = 1.46, 95% CI = 1.23-1.73). Increased risk of T1D was also noted in children born to younger mothers (<25 years) (OR = 1.94, 95% CI = 1.34-2.81), older fathers (>30 years) (OR = 1.56 (95% CI = 1.16-2.10) to 1.57 (95% CI = 1.19-2.05), mothers with Caesarean section (CS) (OR = 2.35, 95% CI = 1.52-3.64), and mothers with gestational diabetes mellitus (OR = 4.36, 95% CI = 2.76-7.77). Fathers with T1D (OR = 7.36, 95% CI = 1.02-57.21) or type 2 diabetes (OR = 1.54, 95% CI = 1.04-2.26) were observed to substantially increase the risk of offspring T1D.
  
  
  CONCLUSIONS
  Certain modifiable perinatal factors such as infection and CS may predispose incidence of T1D in young children.
authors.affiliation: 1 Department and Graduate Institute of Public Health, College of Medical, National Cheng-Kung University, Tainan, Taiwan.
authors.forename: Hsin-Yu
authors.initials: HY
authors.lastname: Lee
authors.affiliation: 1 Department and Graduate Institute of Public Health, College of Medical, National Cheng-Kung University, Tainan, Taiwan 2 Department of Medical Research, Ditmanson Medical Foundation, Chia-Yi Christian Hospital, Chia-Yi City, Taiwan cyli99@mail.ncku.edu.tw.
authors.forename: Chin-Li
authors.initials: CL
authors.lastname: Lu
authors.affiliation: 3 Department of Endocrinology, Far-Eastern Memorial Hospital, New Taipei City, Taiwan.
authors.forename: Hua-Fen
authors.initials: HF
authors.lastname: Chen
authors.affiliation: 4 Department of Health Care Management, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan.
authors.forename: Hui-Fang
authors.initials: HF
authors.lastname: Su
authors.affiliation: 1 Department and Graduate Institute of Public Health, College of Medical, National Cheng-Kung University, Tainan, Taiwan 5 Department of Public Health, College of Public Health, China Medical University, Taichung, Taiwan.
authors.forename: Chung-Yi
authors.initials: CY
authors.lastname: Li
mesh_terms: D001724:Birth Weight; D016022:Case-Control Studies; D002585:Cesarean Section / Q000706:statistics & numerical data; D002648:Child; D002675:Child, Preschool; D003922:Diabetes Mellitus, Type 1 / Q000453:epidemiology*; D005260:Female; D005865:Gestational Age; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007239:Infections / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008423:Maternal Age; D016017:Odds Ratio; D010331:Paternal Age; D012307:Risk Factors; D013624:Taiwan