Maternal Body Mass Index before pregnancy, maternal weight gain during pregnancy, and risk of persistent positivity for multiple diabetes associated autoantibodies in children with the high-risk HLA genotype: The MIDIA study

  1. Trond Rasmussen, MSc (trond.rasmussen{at},
  2. Lars C. Stene, PhD1,
  3. Sven O. Samuelsen, PhD1,2,
  4. Ondrej Cinek, MD, PhD3,
  5. Turid Wetlesen, RN1,
  6. Peter A. Torjesen, PhD4 and
  7. Kjersti S. Rønningen, MD, PhD1
  1. 1 Div. of Epidemiology, Norwegian Institute of Public Health, Oslo, Norway
  2. 2 Dep. of Mathematics, University of Oslo, Norway
  3. 3 Dep. of Paediatrics, Motol University Hospital, Prague, The Czech Republic
  4. 4 Hormone Laboratory, Oslo University Hospital Aker, Oslo, Norway


    Objective: To assess whether maternal body mass index (BMI) before pregnancy and weight gain during pregnancy predicted risk of islet autoimmunity in genetically susceptible children.

    Research Design and Methods: Of 46,939 newborns screened for the high risk HLA genotype DR4-DQ8/DR3-DQ2, 1003 were positive, and 885 were followed with serial blood samples tested for autoantibodies to insulin, GAD and IA2. The endpoint was defined as repeated positivity for two or three autoantibodies or onset of type 1 diabetes (islet autoimmunity).

    Results: Thirty-six children developed islet autoimmunity, of whom ten developed type 1 diabetes. Both maternal BMI >=30 kg/m2 before pregnancy and maternal weight gain of >=15 kg predicted increased risk of islet autoimmunity (HR=2.5, p=0.023 and HR=2.5, p=0.015, respectively), independent of maternal diabetes.

    Conclusion: Maternal weight may predict risk of islet autoimmunity in offspring with high genetic susceptibility for type 1 diabetes.


      • Received April 6, 2009.
      • Accepted June 30, 2009.