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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Breast-feeding and childhood-onset type 1 diabetes: A pooled analysis of individual participant data from 43 observational studies
Diabetes Care, Volume 35, No. 11, Year 2012
Notification
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Description
OBJECTIVE - To investigate if there is a reduced risk of type 1 diabetes in children breastfed or exclusively breastfed by performing a pooled analysis with adjustment for recognized confounders. RESEARCH DESIGN AND METHODS - Relevant studies were identified from literature searches using MEDLINE, Web of Science, and EMBASE. Authors of relevant studies were asked to provide individual participant data or conduct prespecified analyses. Meta-analysis techniques were used to combine odds ratios (ORs) and investigate heterogeneity between studies. RESULTS - Data were available from 43 studies including 9,874 patients with type 1 diabetes. Overall, there was a reduction in the risk of diabetes after exclusive breast-feeding for >2 weeks (20 studies; OR = 0.75, 95% CI 0.64- 0.88), the association after exclusive breast-feeding for >3 months was weaker (30 studies;OR = 0.87, 95%CI 0.75 -1.00), and no association was observed after (nonexclusive) breast-feeding for >2 weeks (28 studies; OR = 0.93, 95% CI 0.81-1.07) or >3 months (29 studies; OR = 0.88, 95% CI 0.78-1.00). These associations were all subject to marked heterogeneity (I 2 = 58, 76, 54, and 68%, respectively). In studies with lower risk of bias, the reduced risk after exclusive breast-feeding for >2 weeks remained (12 studies; OR = 0.86, 95% CI 0.75-0.99), and heterogeneity was reduced (I 2 = 0%). Adjustments for potential confounders altered these estimates very little. CONCLUSIONS - The pooled analysis suggests weak protective associations between exclusive breast-feeding and type 1 diabetes risk. However, these findings are difficult to interpret because of the marked variation in effect and possible biases (particularly recall bias) inherent in the included studies. © 2012 by the American Diabetes Association.
Authors & Co-Authors
Cardwell, Christopher R.
Unknown Affiliation
Stene, Lars C.
Unknown Affiliation
Ludvigsson, Johnny G.
Unknown Affiliation
Rosenbauer, Joachim
Unknown Affiliation
Cinek, Ondr̂ej
Unknown Affiliation
Svensson, Læge Jannet
Unknown Affiliation
Perez-Bravo, Francisco
Unknown Affiliation
Memon, Anjum
Unknown Affiliation
Gimeno, Suely G.
Unknown Affiliation
Wadsworth, Emma J.K.
Unknown Affiliation
Strotmeyer, Elsa S.
Unknown Affiliation
Goldacre, Michael J.
Unknown Affiliation
Radon, Katja
Unknown Affiliation
Chuang, Lee Ming
Unknown Affiliation
Parslow, Roger Charles
Unknown Affiliation
Chetwynd, Amanda G.
Unknown Affiliation
Karavanaki, Kyriaki
Unknown Affiliation
Brigis, Girts
Unknown Affiliation
Pozzilli, Paolo
Unknown Affiliation
Urbonaité, Bronislava K.
Unknown Affiliation
Schober, Edith
Unknown Affiliation
Devoti, Gabriele
Unknown Affiliation
Sipetic, Sandra
Unknown Affiliation
Joner, G.
Unknown Affiliation
Ionescu-Tîrgovişte, Constantin
Unknown Affiliation
de Beaufort, Carine E.
Unknown Affiliation
Harrild, Kirsten A.
Unknown Affiliation
Benson, Victoria
Unknown Affiliation
Savilahti, Erkki M.
Unknown Affiliation
Ponsonby, Anne Louise
Unknown Affiliation
Salem, Mona A.K.
Unknown Affiliation
Rabiei, Samira
Unknown Affiliation
Patterson, Christopher C.
Unknown Affiliation
Statistics
Citations: 71
Authors: 33
Affiliations: 35
Identifiers
Doi:
10.2337/dc12-0438
ISSN:
01495992
e-ISSN:
19355548
Research Areas
Genetics And Genomics
Maternal And Child Health
Noncommunicable Diseases
Study Approach
Systematic review