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. 2000 Aug 12;321(7258):420-4.
doi: 10.1136/bmj.321.7258.420.

Influence of maternal age at delivery and birth order on risk of type 1 diabetes in childhood: prospective population based family study. Bart's-Oxford Family Study Group

P J Bingley  1 , I F Douek, C A Rogers, E A Gale
Affiliations

Influence of maternal age at delivery and birth order on risk of type 1 diabetes in childhood: prospective population based family study. Bart's-Oxford Family Study Group

P J Bingley et al. BMJ. .

Abstract

Objectives: To examine the influence of parental age at delivery and birth order on subsequent risk of childhood diabetes.

Design: Prospective population based family study.

Setting: Area formerly administered by the Oxford Regional Health Authority.

Participants: 1375 families in which one child or more had diabetes. Of 3221 offspring, 1431 had diabetes (median age at diagnosis 10.5 years, range 0.4-28.5) and 1790 remained non-diabetic at a median age of 16. 1 years.

Main outcome measures: Disease free survival and hazard ratios for the development of type 1 diabetes in all offspring, assessed by Cox proportional hazard regression.

Results: Maternal age at delivery was strongly related to risk of type 1 diabetes in the offspring; risk increased by 25% (95% confidence interval 17% to 34%) for each five year band of maternal age, so that maternal age at delivery of 45 years or more was associated with a relative risk of 3.11 (2.07 to 4.66) compared with a maternal age of less than 20 years. Paternal age was also associated with a 9% (3% to 16%) increase for each five year increase in paternal age. The relative risk of diabetes, adjusted for parental age at delivery and sex of offspring, decreased with increasing birth order; the overall effect was a 15% risk reduction (10% to 21%) per child born.

Conclusions: A strong association was found between increasing maternal age at delivery and risk of diabetes in the child. Risk was highest in firstborn children and decreased progressively with higher birth order. The fetal environment seems to have a strong influence on risk of type 1 diabetes in the child. The increase in maternal age at delivery in the United Kingdom over the past two decades could partly account for the increase in incidence of childhood diabetes over this period.

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Figures

Figure 1
Figure 1
Diabetes free survival in offspring in relation to maternal age at delivery
Figure 2
Figure 2
Maternal age at delivery in England and Wales 1970-9, 1980-9, and 1990-6
Figure 3
Figure 3
Estimated risk of childhood diabetes in successive annual birth cohorts compared with 1970 cohort, calculated by using maternal age distribution and estimated disease free survival for each age group
See this image and copyright information in PMC

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