Evidence map›Paper›PMID 35488031›Full record

ArticlePediatric research2023

Early exposures and inherent factors in premature newborns are associated with type 1 diabetes.

Iren Zargari, Adi Adar, Iris Morag, Orit Pinhas-Hamiel, Ori Eyal, Rimona Keidar, Neta Loewenthal, Milana Levy, Orna Dally-Gottfried, Zohar Landau and 5 more

Erratum issuedAbstract readMulticenter Study
PubMed Publisher
In one paragraph

Article in Pediatric research, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
0.4field-weighted citation impact, top 34% of its field
1 · What the graph read from 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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it, 3 citations in OpenAlex.

  1. Pooled it
  2. Group BAntibiotics (Basel, Switzerland) · 2023
    Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

15 authors at 9 institutions in 1 country.

Iren ZargariPediatric Endocrinology Unit, Division of Pediatrics, Shamir Medical Center (Assaf Harofeh), Zerifin, Israel.
Adi AdarPediatric Endocrinology Unit, Division of Pediatrics, Shamir Medical Center (Assaf Harofeh), Zerifin, Israel.
Iris MoragSackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
Orit Pinhas-HamielSackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
Ori EyalSackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
Rimona KeidarSackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
Neta LoewenthalPediatric Endocrinology and Metabolic Unit, Soroka University Medical Center, Beer Sheva, Israel.
Milana LevyPediatric Diabetes and Obesity Clinic, Ruth Rappaport Children's Hospital, Rambam Health Care Campus, Haifa, Israel.
Orna Dally-GottfriedThe Center for Juvenile Diabetes and Pediatric Endocrinology and Pediatric Outpatient Clinics, Rebecca Ziv Hospital, affiliated to The School of Medicine, Bar Ilan University, Safed, Israel.
Zohar LandauSackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
Floris Levy-KhademiThe School of Medicine in the Hebrew University of Jerusalem, Jerusalem, Israel.
Smadar Eventov-FriedmanThe School of Medicine in the Hebrew University of Jerusalem, Jerusalem, Israel.
David ZangenThe School of Medicine in the Hebrew University of Jerusalem, Jerusalem, Israel.
Ilan YoungsterSackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
Marianna RachmielPediatric Endocrinology Unit, Division of Pediatrics, Shamir Medical Center (Assaf Harofeh), Zerifin, Israel. mariannar@shamir.gov.il.
Tel Aviv University · ILHebrew University of Jerusalem · ILSheba Medical Center · ILBar-Ilan University · ILHadassah Medical Center · ILRambam Health Care Campus · ILSoroka Medical Center · ILTel Aviv Sourasky Medical Center · ILWolfson Medical Center · IL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPathophysiology of type 1 diabetes (T1D) involves immune responses that may be associated with early exposure to environmental factors among preterm newborns. The aim of this work was to evaluate for association between T1D and maternal, nutritional, and medical exposures during the neonatal period among premature newborns.

methodsThis is a multicenter, matched case-control study. Preterm newborns, who developed T1D before 18 years, were matched by sex, gestational age (GA), birth date, and medical center of birth with newborns who did not develop TID. Data included maternal medical history, birth weight (BW), length of hospitalization, enteral and parenteral medications, fluid administration, and feeding modalities during hospitalization.

resultsFifty-two patients with T1D, 26 males, median age at T1D diagnosis 8.17 years (5.92-9.77), median GA 34 weeks (33-m36), and 132 matched controls, were included. Multivariate-conditional-regression demonstrated a significant association between T1D and any maternal illness (23.1% vs. 9.1%, OR = 4.99 (1.69-14.72), p = 0.004), higher BW-SDS (0.07 ± 0.95 vs. -0.27 ± 0.97, OR = 2.03 (1.19-3.49), p = 0.01), longer duration of glucose infusion (3 (1-5) days vs. 2 (0-4), OR = 1.23 (1.03-1.46), p = 0.02), and antibiotic therapy beyond the first week of life (19.2% vs. 6.9%, OR = 5.22 (1.32-20.70), p = 0.019). Antibiotic treatment during the first week of life was negatively associated with T1D (51.9% vs. 67.2%, OR 0.31 (0.11-0.88), p = 0.027).

conclusionsA novel association was demonstrated between the development of T1D and early interventions and exposures among preterm newborns. IMPACT: Type 1 diabetes mellitus during childhood may be associated with early exposures during the neonatal period, in addition to known maternal and neonatal metabolic parameters. Early exposure to intravenous antibiotics, differing between the first week of life and later, and longer parenteral glucose administration to preterm newborns were associated with childhood type 1 diabetes. This is in addition to familiar maternal risk factors. Future prospective studies should examine the microbial changes and immune system characteristics of preterm and term neonates exposed to parenteral antibiotics and glucose treatment, in order to validate our exploratory findings.

Indexed as

Diabetes Mellitus, Type 1Infant, Newborn, DiseasesPregnancy ComplicationsPremature BirthAnti-Bacterial AgentsBirth WeightCase-Control StudiesChildFemaleGlucoseHumansInfant, NewbornMaleProspective StudiesAnti-Bacterial AgentsGlucose

Identifiers

PMID35488031
OpenAlexW4225123886

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.