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Congenital infections as contributors to the onset of diabetes in children: A longitudinal study in the United States, 2001‐2017
Author(s) -
Rogers Mary A. M.,
Kim Catherine
Publication year - 2020
Publication title -
pediatric diabetes
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.678
H-Index - 75
eISSN - 1399-5448
pISSN - 1399-543X
DOI - 10.1111/pedi.12957
Subject(s) - medicine , diabetes mellitus , pediatrics , longitudinal study , type 1 diabetes , environmental health , endocrinology , pathology
Background Maternal infections during pregnancy, particularly with rubella virus, were reported to increase the risk of diabetes in children. Widespread vaccination has decreased the number of infants with congenital rubella syndrome in the United States, although it remains a problem in developing countries. Because vaccine hesitancy has recently increased, we investigated the association between congenital infections with subsequent diabetes risk in children in the United States. Methods Using data from a nationwide private health insurer for years 2001‐2017, 1 475 587 infants were followed for an average of 3.9 years (maximum 16.5 years). Information was obtained regarding congenital infections (rubella, cytomegalovirus, other congenital infections) and perinatal infections, as well as for the development of diabetes mellitus and diabetic ketoacidosis. Results There were 781 infants with congenital infections and 73 974 with perinatal infections. Diabetes developed in 3334 children. The odds of developing diabetes for infants with congenital rubella infection were 12‐fold greater ( P = .013) and, for infants with congenital cytomegalovirus infection, were 4‐fold greater ( P = .011) than infants without congenital or perinatal infection. Infants with other congenital infections had 3‐fold greater odds of developing diabetes ( P = .044). Results were similar for diabetes ketoacidosis. Infants with other perinatal infections had 49% greater odds of developing diabetes during the follow‐up period ( P < .001). Conclusion Congenital and other perinatal infections are associated with elevated risks of developing diabetes mellitus during childhood. Vaccination for rubella remains an important preventive action to reduce the incidence of diabetes in children.