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Maternal smoking during pregnancy and the risk of childhood type 1 diabetes in Western Australia

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Abstract

Aims/hypothesis

The aim of this study was to investigate the association between maternal smoking during pregnancy and type 1 diabetes in the offspring, using complete population data sources available in Western Australia.

Methods

A prospective cohort study was undertaken with cases defined as children born in Western Australia between 1998 and 2008 who were diagnosed with type 1 diabetes at <15 years of age up to 31 December 2010. Eligible cases were identified from the prospective, population-based Western Australian Children’s Diabetes Database. Record linkage was performed to identify perinatal records of cases from the Western Australian Midwives’ Notification System, which contains data on >99% of all births in Western Australia. Cox regression was used to analyse the data and adjust for recognised risk factors such as birthweight, gestational age, maternal age and socioeconomic status.

Results

The unadjusted HR for babies born to mothers who smoked during pregnancy being diagnosed with childhood type 1 diabetes was 0.70 (95% CI: 0.50, 0.97). After adjustment, the confidence interval widened but the point estimate remained relatively unchanged at 0.76 (95% CI: 0.54, 1.08).

Conclusions/interpretation

Analyses of data from this population-based study indicate that maternal smoking during pregnancy may be associated with a reduced risk of childhood type 1 diabetes. Further investigation in larger populations with more detailed smoking data could lead to novel hypotheses regarding mechanisms that influence the immunopathogenesis of type 1 diabetes in early life.

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Fig. 1

Abbreviations

MNS:

Midwives’ Notification System

WACDD:

Western Australia Childhood Diabetes Database

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Acknowledgements

We would like to thank the Data Linkage Branch (Western Australian Department of Health) for performing the record linkage for this study, and the custodians of the MNS (Western Australian Department of Health) for their assistance in helping us to interpret the perinatal data variables available.

Duality of interest

The authors declare that there is no duality of interest associated with this manuscript.

Contribution statement

AH contributed to the study conception and design, reviewed the literature, performed the study, analysed the data, interpreted the results and wrote the manuscript. MNC contributed to the study design, prepared the data, reviewed the analyses and edited the manuscript. CB contributed to the conception, design and interpretation of the study and reviewed/edited the manuscript. EAD and TWJ contributed to the study conception, interpretation of results and reviewed/edited the manuscript. All authors approved the final version.

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Authors and Affiliations

  1. Department of Endocrinology and Diabetes, Princess Margaret Hospital for Children, GPO Box D184, Perth, WA, 6840, Australia

    Aveni Haynes, Timothy W. Jones & Elizabeth A. Davis

  2. Telethon Institute for Child Health Research, The University of Western Australia, Perth, WA, Australia

    Aveni Haynes, Matthew N. Cooper, Carol Bower, Timothy W. Jones & Elizabeth A. Davis

  3. School of Paediatrics and Child Health, The University of Western Australia, Perth, WA, Australia

    Timothy W. Jones & Elizabeth A. Davis

Authors
  1. Aveni Haynes
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  2. Matthew N. Cooper
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  3. Carol Bower
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  4. Timothy W. Jones
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  5. Elizabeth A. Davis
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Corresponding author

Correspondence to Elizabeth A. Davis.

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Haynes, A., Cooper, M.N., Bower, C. et al. Maternal smoking during pregnancy and the risk of childhood type 1 diabetes in Western Australia. Diabetologia 57, 469–472 (2014). https://doi.org/10.1007/s00125-013-3122-7

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  • DOI: https://doi.org/10.1007/s00125-013-3122-7

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