Prenatal exposure to bereavement and type-2 diabetes: a Danish longitudinal population based study

The etiology of type-2 diabetes is only partly known, and a possible role of prenatal stress in programming offspring for insulin resistance has been suggested by animal models. Previously, we found an association between prenatal stress and type-1 diabetes. Here we examine the association between p...

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Veröffentlicht in:PloS one 2012-08, Vol.7 (8), p.e43508
Hauptverfasser: Virk, Jasveer, Li, Jiong, Vestergaard, Mogens, Obel, Carsten, Kristensen, Jette Kolding, Olsen, Jørn
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Li, Jiong
Vestergaard, Mogens
Obel, Carsten
Kristensen, Jette Kolding
Olsen, Jørn
description The etiology of type-2 diabetes is only partly known, and a possible role of prenatal stress in programming offspring for insulin resistance has been suggested by animal models. Previously, we found an association between prenatal stress and type-1 diabetes. Here we examine the association between prenatal exposure to maternal bereavement during preconception and pregnancy and development of type-2 diabetes in the off-spring. We utilized data from the Danish Civil Registration System to identify singleton births in Denmark born January 1(st) 1979 through December 31(st) 2008 (N = 1,878,246), and linked them to their parents, grandparents, and siblings. We categorized children as exposed to bereavement during prenatal life if their mothers lost an elder child, husband or parent during the period from one year before conception to the child's birth. We identified 45,302 children exposed to maternal bereavement; the remaining children were included in the unexposed cohort. The outcome of interest was diagnosis of type-2 diabetes. We estimated incidence rate ratios (IRRs) from birth using log-linear poisson regression models and used person-years as the offset variable. All models were adjusted for maternal residence, income, education, marital status, sibling order, calendar year, sex, and parents' history of diabetes at the time of pregnancy. We found children exposed to bereavement during their prenatal life were more likely to have a type-2 diabetes diagnosis later in life (aIRR: 1.31, 1.01-1.69). These findings were most pronounced when bereavement was caused by death of an elder child (aIRR: 1.51, 0.94-2.44). Results also indicated the second trimester of pregnancy to be the most sensitive period of bereavement exposure (aIRR:2.08, 1.15-3.76). Our data suggests that fetal exposure to maternal bereavement during preconception and the prenatal period may increase the risk for developing type-2 diabetes in childhood and young adulthood.
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We estimated incidence rate ratios (IRRs) from birth using log-linear poisson regression models and used person-years as the offset variable. All models were adjusted for maternal residence, income, education, marital status, sibling order, calendar year, sex, and parents' history of diabetes at the time of pregnancy. We found children exposed to bereavement during their prenatal life were more likely to have a type-2 diabetes diagnosis later in life (aIRR: 1.31, 1.01-1.69). These findings were most pronounced when bereavement was caused by death of an elder child (aIRR: 1.51, 0.94-2.44). Results also indicated the second trimester of pregnancy to be the most sensitive period of bereavement exposure (aIRR:2.08, 1.15-3.76). 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Previously, we found an association between prenatal stress and type-1 diabetes. Here we examine the association between prenatal exposure to maternal bereavement during preconception and pregnancy and development of type-2 diabetes in the off-spring. We utilized data from the Danish Civil Registration System to identify singleton births in Denmark born January 1(st) 1979 through December 31(st) 2008 (N = 1,878,246), and linked them to their parents, grandparents, and siblings. We categorized children as exposed to bereavement during prenatal life if their mothers lost an elder child, husband or parent during the period from one year before conception to the child's birth. We identified 45,302 children exposed to maternal bereavement; the remaining children were included in the unexposed cohort. The outcome of interest was diagnosis of type-2 diabetes. 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Previously, we found an association between prenatal stress and type-1 diabetes. Here we examine the association between prenatal exposure to maternal bereavement during preconception and pregnancy and development of type-2 diabetes in the off-spring. We utilized data from the Danish Civil Registration System to identify singleton births in Denmark born January 1(st) 1979 through December 31(st) 2008 (N = 1,878,246), and linked them to their parents, grandparents, and siblings. We categorized children as exposed to bereavement during prenatal life if their mothers lost an elder child, husband or parent during the period from one year before conception to the child's birth. We identified 45,302 children exposed to maternal bereavement; the remaining children were included in the unexposed cohort. The outcome of interest was diagnosis of type-2 diabetes. We estimated incidence rate ratios (IRRs) from birth using log-linear poisson regression models and used person-years as the offset variable. All models were adjusted for maternal residence, income, education, marital status, sibling order, calendar year, sex, and parents' history of diabetes at the time of pregnancy. We found children exposed to bereavement during their prenatal life were more likely to have a type-2 diabetes diagnosis later in life (aIRR: 1.31, 1.01-1.69). These findings were most pronounced when bereavement was caused by death of an elder child (aIRR: 1.51, 0.94-2.44). Results also indicated the second trimester of pregnancy to be the most sensitive period of bereavement exposure (aIRR:2.08, 1.15-3.76). Our data suggests that fetal exposure to maternal bereavement during preconception and the prenatal period may increase the risk for developing type-2 diabetes in childhood and young adulthood.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>22952698</pmid><doi>10.1371/journal.pone.0043508</doi><tpages>e43508</tpages><oa>free_for_read</oa></addata></record>
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subjects Adolescent
Adult
Age
Analysis
Animal models
Animals
Bereavement
Birth
Child
Child, Preschool
Children
Children & youth
Cohort Studies
Complications and side effects
Critical period
Dehydrogenases
Denmark
Development and progression
Diabetes
Diabetes mellitus
Diabetes Mellitus, Type 2 - metabolism
Diagnosis
Education
Endocrinology
Etiology
Exposure
Female
Fetuses
Grief
Handbooks
Health risk assessment
Health risks
Hospitals
Humans
Hypertension
Infant
Infant, Newborn
Insulin
Insulin resistance
Longitudinal Studies
Male
Marital status
Maternal Exposure
Medicine
Mothers
Offspring
Parent educational background
Parents
Physiology
Poisson density functions
Population studies
Population-based studies
Pregnancy
Pregnancy Trimester, Second
Pregnant women
Prenatal experience
Prenatal exposure
Prenatal Exposure Delayed Effects - epidemiology
Prognosis
Psychological aspects
Public health
Registration
Regression analysis
Regression models
Risk factors
Social and Behavioral Sciences
Statistical analysis
Stress
Type 2 diabetes
title Prenatal exposure to bereavement and type-2 diabetes: a Danish longitudinal population based study
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