Abstract：
OBJECTIVE: To evaluate the association between perinatal and obstetric factors as potential triggers for the early onset of T1DM.
METHODS: This was a retrospective cohort study enrolling 409 patients diagnosed with T1DM, in Bauru, São Paulo, Brazil, from 1981 to 2023. Data were retrieved from medical records, regarding sociodemographic parameters as age, sex, ethnicity, and socioeconomic status. Perinatal and obstetric factors as delivery type, gestational age, filiation order, length of exclusive breastfeeding, maternal age, maternal and fetal blood types, and occurrence of maternal gestational diabetes were also analyzed. An adapted survival analysis was employed to gauge the impact of each assessed variable at the age of T1DM diagnosis.
RESULTS: The median age of T1DM diagnosis was 10.3 years with an interquartile range between 6.4 and 15.5 years. Delivery type and filiation order were the only factors statistically significantly associated with an early age at T1DM diagnosis. Patients who were born through cesarean section and who were firstborns showed a 28.6 and 18.0 % lower age at T1DM diagnosis, respectively, compared to those born through vaginal delivery and those that were nonfirstborns.
CONCLUSIONS: Being born by cesarean section and being firstborn showed to be statistically significant factors to determine an early T1DM diagnosis.
METHODS: This was a retrospective cohort study enrolling 409 patients diagnosed with T1DM, in Bauru, São Paulo, Brazil, from 1981 to 2023. Data were retrieved from medical records, regarding sociodemographic parameters as age, sex, ethnicity, and socioeconomic status. Perinatal and obstetric factors as delivery type, gestational age, filiation order, length of exclusive breastfeeding, maternal age, maternal and fetal blood types, and occurrence of maternal gestational diabetes were also analyzed. An adapted survival analysis was employed to gauge the impact of each assessed variable at the age of T1DM diagnosis.
RESULTS: The median age of T1DM diagnosis was 10.3 years with an interquartile range between 6.4 and 15.5 years. Delivery type and filiation order were the only factors statistically significantly associated with an early age at T1DM diagnosis. Patients who were born through cesarean section and who were firstborns showed a 28.6 and 18.0 % lower age at T1DM diagnosis, respectively, compared to those born through vaginal delivery and those that were nonfirstborns.
CONCLUSIONS: Being born by cesarean section and being firstborn showed to be statistically significant factors to determine an early T1DM diagnosis.
摘要：
目的：评估围产期和产科因素作为T1DM早期发病的潜在诱因之间的相关性。
方法：这是一项回顾性队列研究，纳入409例诊断为T1DM的患者，在Bauru,圣保罗,巴西,从1981年到2023年。数据是从医疗记录中检索出来的,将社会人口统计学参数视为年龄，性别,种族,和社会经济地位。围产期和产科因素作为分娩类型，胎龄,亲子关系令，纯母乳喂养的长度，产妇年龄,孕妇和胎儿的血型，并对孕妇妊娠期糖尿病的发生情况进行分析。采用适应性生存分析来评估每个评估变量在T1DM诊断年龄的影响。
结果：诊断为T1DM的中位年龄为10.3岁，四分位距在6.4至15.5岁之间。分娩类型和分娩顺序是与T1DM诊断早期年龄统计学上显著相关的唯一因素。通过剖宫产出生的患者和头胎在T1DM诊断时显示出28.6％和18.0％的低年龄。分别,与通过阴道分娩出生的人和非长子出生的人相比。
结论：剖宫产和长胎是确定T1DM早期诊断的统计学显著因素。
方法：这是一项回顾性队列研究，纳入409例诊断为T1DM的患者，在Bauru,圣保罗,巴西,从1981年到2023年。数据是从医疗记录中检索出来的,将社会人口统计学参数视为年龄，性别,种族,和社会经济地位。围产期和产科因素作为分娩类型，胎龄,亲子关系令，纯母乳喂养的长度，产妇年龄,孕妇和胎儿的血型，并对孕妇妊娠期糖尿病的发生情况进行分析。采用适应性生存分析来评估每个评估变量在T1DM诊断年龄的影响。
结果：诊断为T1DM的中位年龄为10.3岁，四分位距在6.4至15.5岁之间。分娩类型和分娩顺序是与T1DM诊断早期年龄统计学上显著相关的唯一因素。通过剖宫产出生的患者和头胎在T1DM诊断时显示出28.6％和18.0％的低年龄。分别,与通过阴道分娩出生的人和非长子出生的人相比。
结论：剖宫产和长胎是确定T1DM早期诊断的统计学显著因素。
