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The Importance of Older Maternal Age Other Birth- Related Factors as Predictors for Diabetes in Offspring: Particular Implications for First Nations Women?

      ABSTRACT

      AIMS: To examine the association of birth-related factors with diabetes risk in offspring.
      METHODS: We evaluated the relationship between maternal age, maternal parity and birth weight with diabetes in offspring using a case–control design and conditional logistic regression. Administrative databases linked to vital statistics identified 1366 First Nations people (FN) with diabetes and 1366 other Saskatchewan residents (OSK) with diabetes for comparison with their nondiabetic counterparts.
      RESULTS: In final models, each 1 kg increase in birth weight elevated diabetes risk among FN (OR 1.23, 95% CI 1.01-1.50) and OSK (OR 1.16, 95% CI 0.98-1.38) offspring. Among FN, advancing maternal age interacted with offspring sex to increase diabetes risk 4% per year for males (OR 1.04, 95% CI 1.01-1.06) and 8% per year for females (OR 1.08; 95% CI 1.06-1.10). Each year of maternal age increased diabetes risk among OSK offspring in an interaction with maternal parity (OR 1.09, 95% CI 1.06-1.11 for parity 1–4; OR 1.04, 95% CI 1.001-1.08 for parity >5).
      CONCLUSIONS: The combination of increasing maternal age and birth weight were predictors for diabetes, particularly in female FN offspring. This is consistent with a diabetogenic effect of diabetic pregnancies, since both variables are independently associated with maternal gestational diabetes, intergenerational, intragenerational, maternal age, maternal parity, Registered Indians, type 2 diabetes.

      RÉSUMÉ

      OBJECTIF : Examiner le lien entre des facteurs associes a la naissance et le risque de diabete chez les descendants.
      METHODES : Nous avons mene une etude cas temoins avec regression logistique conditionnelle pour evaluer le rapport entre le diabete et l'age maternel, la parite maternelle et le poids de naissance. Des bases de donnees administratives en lien avec les statistiques de l'etat civil ont permis de reperer 1366 membres des Premieres nations (MPN) atteints de diabete et 1366 autres residants de la Saskatchewan (ARS) atteints de diabete en vue d'une comparaison avec des personnes ne souffrant pas de diabete.
      RESULTATS : Dans les modeles finals, pour chaque kilogramme d'augmentation du poids de naissance, il y avait une augmentation du risque de diabete chez les descendants des MPN (RC : 1,23; IC de 95 % : 1,01-1,50) et des ARS (RC : 1,16; IC de 95 % : 0,98-1,38). Parmi les MPN, il y avait un lien entre l'age maternel et le risque de diabete chez les descendants : ce risque augmentait de 4 % par annee d'age maternel chez les descendants de sexe masculin (RC : 1,04; IC de 95 % : 1,01-1,06) et de 8 % par annee d'age maternel chez les descendants de sexe feminin (RC : 1,08; IC de 95 % : 1,06-1,10). Chaque annee d'age maternel augmentait le risque de diabete chez les descendants des ARS en fonction de la parite de la mere (RC : 1,09; IC de 95 % : 1,06-1,11 quand la mere avait eu entre 1 et 4 enfants; RC : 1,04; IC de 95 % : 1,001-1,08 quand la mere avait eu plus de 5 enfants).
      CONCLUSIONS : La combinaison d'un age maternel eleve et d'un poids de naissance eleve etait un predicteur de diabete, surtout chez les descendants de sexe feminin des MPN. Cette observation est conforme avec l'effet diabetogene de la grossesse diabetique, car les deux variables sont independamment associees au diabete gestationnel chez la mere.
      MOTS CLES : poids de naissance, age maternel, parite maternelle, diabete de type 2, Autochtone, Indiens inscrits, Premieres nations, grossesse diabetique, diabete gestationnel, intergenerationnel, intragenerationnel, origines foe tales du diabete

      KEYWORDS

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