SynthesisDiabetologia2008
Caesarean section is associated with an increased risk of childhood-onset type 1 diabetes mellitus: a meta-analysis of observational studies.
Synthesis in Diabetologia, 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06282952 (Section-Born Infants and SUccessful Health Outcomes After Fecal Microbiota Transplantation), which is not on this map. Cited by 232 papers, 7 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Section-Born Infants and SUccessful Health Outcomes After Fecal Microbiota Transplantation (SISU-FMT)
Who cites it
232 citing papers in PubMed, 7 syntheses or guidelines pooled it, 590 citations in OpenAlex.
- Microbiome and pediatric leukemia, diabetes, and allergies: Systematic review and meta-analysis.PloS one · 2025Pooled it
- Effect of probiotics and related supplements on glycemic control in pediatric patients with type 1 diabetes mellitus: a systematic review and meta-analysis of clinical trials.Frontiers in pediatrics · 2025Pooled it
- Association of cesarean section with asthma in children/adolescents: a systematic review and meta-analysis based on cohort studies.BMC pediatrics · 2023Pooled it
- Pediatrics Consequences of Caesarean Section-A Systematic Review and Meta-Analysis.International journal of environmental research and public health · 2020Pooled it
- Risk of Type 1 Diabetes in the Offspring Born through Elective or Non-elective Caesarean Section in Comparison to Vaginal Delivery: a Meta-Analysis of Observational Studies.Current diabetes reports · 2019Pooled it
- Association of Cesarean Delivery With Risk of Neurodevelopmental and Psychiatric Disorders in the Offspring: A Systematic Review and Meta-analysis.JAMA network open · 2019Pooled it
- The mode of delivery affects the diversity and colonization pattern of the gut microbiota during the first year of infants' life: a systematic review.BMC gastroenterology · 2016Pooled it
- Early probiotic supplementation with B. infantis in breastfed infants leads to persistent colonization at 1 year.Pediatric research · 2022Trial
- Estimating the effect of cesarean delivery on long-term childhood health across two countries.PloS one · 2022Trial
- Cesarean delivery on maternal request and common child health outcomes: A prospective cohort study in China.Journal of global health · 2022Trial
- Trial
- Probiotic supplementation restores normal microbiota composition and function in antibiotic-treated and in caesarean-born infants.Microbiome · 2018Trial
- Assessing age-related etiologic heterogeneity in the onset of islet autoimmunity.BioMed research international · 2015Trial
- Health outcomes following caesarean birth- An observational study of twins discordant for mode of delivery.European journal of obstetrics & gynecology and reproductive biology: X · 2026Article
- The Gut-Pancreas Axis in Type 1 Diabetes: Emerging Insights into Microbiota and Immune Interactions.International journal of molecular sciences · 2026Review
- Plant-derived bioactives in early-life complementary foods: a nutritional blueprint for lifelong health.Journal of advanced research · 2026Review
- Caesarean section may be associated with suspected motor developmental delay at 3 years of age in the Japan Environment and Children's Study.Scientific reports · 2026Article
- Childhood acute leukemia and type 1 diabetes in children: A nationwide case-control study.International journal of cancer · 2026Article
- Is the NOD mouse a good model for type 1 diabetes?Diabetologia · 2026Review
- Neonatal and Birth Risk Factors for Type 1 Diabetes Mellitus: Prediction Using an Artificial Neural Network.Life (Basel, Switzerland) · 2025Article
172 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
18 authors at 13 institutions in 9 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aims/hypothesisThe aim of this study was to investigate the evidence of an increased risk of childhood-onset type 1 diabetes in children born by Caesarean section by systematically reviewing the published literature and performing a meta-analysis with adjustment for recognised confounders.
methodsAfter MEDLINE, Web of Science and EMBASE searches, crude ORs and 95% CIs for type 1 diabetes in children born by Caesarean section were calculated from the data reported in each study. Authors were contacted to facilitate adjustments for potential confounders, either by supplying raw data or calculating adjusted estimates. Meta-analysis techniques were then used to derive combined ORs and to investigate heterogeneity between studies.
resultsTwenty studies were identified. Overall, there was a significant increase in the risk of type 1 diabetes in children born by Caesarean section (OR 1.23, 95% CI 1.15-1.32, p < 0.001). There was little evidence of heterogeneity between studies (p = 0.54). Seventeen authors provided raw data or adjusted estimates to facilitate adjustments for potential confounders. In these studies, there was evidence of an increase in diabetes risk with greater birthweight, shorter gestation and greater maternal age. The increased risk of type 1 diabetes after Caesarean section was little altered after adjustment for gestational age, birth weight, maternal age, birth order, breast-feeding and maternal diabetes (adjusted OR 1.19, 95% CI 1.04-1.36, p = 0.01). CONCLUSIONS/
interpretationThis analysis demonstrates a 20% increase in the risk of childhood-onset type 1 diabetes after Caesarean section delivery that cannot be explained by known confounders.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.