Pre-pregnancy body mass index in mothers, birth weight and the risk of type I diabetes in their offspring: A dose-response meta-analysis of cohort studies

Haiyan Wang, Zhongmin Zhang, Yanfang Liu, Jiaqi Yang, Jinhuan Zhang, Cain Clark, David Avelar Rodriguez, Palanisamy Amirthalingam, Yanwei Guo

Research output: Contribution to journalReview articlepeer-review


BACKGROUND: The incidence of type I diabetes among children has increased significantly and the relationship between maternal pre-pregnancy Body Mass Index (BMI), Birth weight and risk of Type 1 diabetes in children (T1DMC) is controversial.

OBJECTIVE: This dose-response meta-analysis was performed to investigate the association between maternal Pre-Pregnancy Body-Mass Index, Birth Weight and the Risk of Childhood Type I Diabetes.

SEARCH STRATEGY: A comprehensive systematic search was conducted in MEDLINE/PubMed, SCOPUS, Cochrane, and Web of Science databases from inception to April 2019. Key search terms included "body mass index" OR "Birth weight" AND "Type 1 diabetes".

SELECTION CRITERIA: Peer-reviewed studies that reporting association between BMI or birth weight and type I diabetes in a retrospective or prospective study by appropriate estimates such as the hazard ratio (HR), risk ratio (RR), or odds ratio (OR) and the corresponding 95 % confidence intervals (CI).

DATA COLLECTION AND ANALYSIS: MOOSE guidelines were followed. Data were extracted by 2 researchers, independently. Combined hazard ratios (HRs) was evaluated by DerSimonian and Laird Random-effects model.

RESULTS: Two studies continuing four arms with 1,209,122 participants were eligible for pre-pregnancy BMI section meta-analysis and six studies were eligible for inclusion, providing 10,340,036 participants for birth weight section meta-analysis. Pooled results demonstrated a significant association between obesity and risk of T1DMC (HR: 1.30, 95 % CI: 1.16-1.46, I2 = 7%). The combined HR (95 % CI) showed lower risk of T1DMC in low birth weight infants (HR: 0.78, 95 % CI: 0.69-0.88, I2 = 0%) and higher risk of T1DMC in the high birth weight infants versus the normal category of birth weight (HR: 1.08, 95 % CI: 1.00-1.17, I2 = 31 %). There was a significant non-linear association between birth weight and risk of T1DMC in children (Coef =-0.00032, p = 0.001).

CONCLUSIONS AND RELEVANCE: This systematic review and meta-analysis identified high maternal BMI and High birth weight (HBW) increase risk of childhood T1DMC.

Original languageEnglish
Article number101921
JournalJournal of Gynecology Obstetrics and Human Reproduction
Issue number2
Early online date28 Sep 2020
Publication statusPublished - Feb 2021

Bibliographical note

Copyright © 2020 Elsevier Masson SAS. All rights reserved.


Research on Correlation between Fetal Intestinal Flora and Adverse Pregnancy Outcomes in GDM Pregnant Women (Project Number: 201801A 057)


  • Type I diabetes
  • Body mass index
  • Birth weight
  • Childhood
  • Obesity

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