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Epidemiology. 2018 Nov;29(6):848-856. doi: 10.1097/EDE.0000000000000911.

Parental Smoking and Risk of Childhood-onset Type 1 Diabetes.

Author information

1
From the Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway.
2
MRC Integrative Epidemiology Unit at University of Bristol, Bristol, United Kingdom.
3
Department of Population Health Sciences, Bristol Medical School, Bristol, United Kingdom.
4
Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway.
5
Centre for Fetal Programming, Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark.
6
Department of Clinical Science, University of Bergen, Bergen, Norway.
7
Laboratory of Clinical Biochemistry, Haukeland University Hospital, Bergen, Norway.
8
Bevital AS, Bergen, Norway.
9
Department of Pediatrics, Copenhagen University Hospital, Herlev, Denmark.
10
Division of Pediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway.
11
Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
12
Department of Pediatrics and Adolescent Medicine, Haukeland University Hospital, Bergen, Norway.
13
KG Jebsen Center for Diabetes Research, Department of Clinical Science, University of Bergen, Bergen, Norway.
14
Department of Pediatrics, Østfold Hospital Trust, Grålum, Norway.

Abstract

BACKGROUND:

A few prospective studies suggest an association between maternal smoking during pregnancy and lower risk of type 1 diabetes. However, the role of unmeasured confounding and misclassification remains unclear.

METHODS:

We comprehensively evaluated whether maternal smoking in pregnancy predicts lower risk of childhood-onset type 1 diabetes in two Scandinavian pregnancy cohorts (185,076 children; 689 cases) and a Norwegian register-based cohort (434,627 children; 692 cases). We measured cord blood cotinine as an objective marker of nicotine exposure during late pregnancy in 154 cases and 476 controls. We also examined paternal smoking during pregnancy, in addition to environmental tobacco smoke exposure the first 6 months of life, to clarify the role of characteristics of smokers in general.

RESULTS:

In the pregnancy cohorts, maternal smoking beyond gestational week 12 was inversely associated with type 1 diabetes, pooled adjusted hazard ratio (aHR) 0.66 (95% CI = 0.51, 0.85). Similarly, in the Norwegian register-based cohort, children of mothers who still smoked at the end of pregnancy had lower risk of type 1 diabetes, aHR 0.65 (95% CI = 0.47, 0.89). Cord blood cotinine ≥30 nmol/L was also associated with reduced risk of type 1 diabetes, adjusted odds ratio 0.42 (95% CI = 0.17, 1.0). We observed no associations of paternal smoking during pregnancy, or environmental tobacco smoke exposure, with childhood-onset type 1 diabetes.

CONCLUSION:

Maternal sustained smoking during pregnancy is associated with lower risk of type 1 diabetes in children. This sheds new light on the potential intrauterine environmental origins of the disease.

PMID:
30074542
PMCID:
PMC6169737
[Available on 2019-11-01]
DOI:
10.1097/EDE.0000000000000911
[Indexed for MEDLINE]

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