Maternal Enterovirus Infection as a Risk Factor for Type 1 Diabetes in the Exposed Offspring
- Hanna Viskari, MD, PHD1,2⇓,
- Mikael Knip, MD, PHD3,4,5,
- Sisko Tauriainen, PHD1,
- Heini Huhtala, MSC6,
- Riitta Veijola, MD, PHD7,
- Jorma Ilonen, MD, PHD8,9,
- Olli Simell, MD, PHD10,
- Heljä-Marja Surcel, MD, PHD11 and
- Heikki Hyöty, MD, PHD1,12
- 1Department of Virology, University of Tampere, School of Medicine, Tampere, Finland
- 2Department of Internal Medicine, Tampere University Hospital, Tampere, Finland
- 3Children’s Hospital, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
- 4Folkhälsan Research Center, Helsinki, Finland
- 5Department of Pediatrics, Tampere University Hospital, Tampere, Finland
- 6Tampere School of Health Sciences, University of Tampere, Tampere, Finland
- 7Department of Pediatrics, University of Oulu, Oulu, Finland
- 8Immunogenetics Laboratory, University of Turku, Turku, Finland
- 9Department of Clinical Microbiology, University of Eastern Finland, Kuopio, Finland
- 10Department of Pediatrics, University Hospital of Turku, Turku, Finland
- 11National Institute for Health and Welfare, Oulu, Finland
- 12Department of Clinical Microbiology, Center for Laboratory Medicine, Tampere University Hospital, Tampere, Finland
- Corresponding author: Hanna Viskari, .
OBJECTIVE Maternal enterovirus infections during pregnancy have been linked to an increased risk of type 1 diabetes in the offspring. The aim of this study was to evaluate this association in a unique series of pregnant mothers whose child progressed to clinical type 1 diabetes.
RESEARCH DESIGN AND METHODS Maternal and in utero enterovirus infections were studied in 171 offspring who presented with type 1 diabetes before the age of 11 years and in 316 control subjects matched for date and place of birth, gender, and HLA-DQ risk alleles for diabetes. Acute enterovirus infections were diagnosed by increases in enterovirus IgG and IgM in samples taken from the mother at the end of the first trimester of pregnancy and cord blood samples taken at delivery.
RESULTS Signs of maternal enterovirus infection were observed in altogether 19.3% of the mothers of affected children and in 12.0% of the mothers of control children (P = 0.038). This difference was seen in different HLA risk groups and in both genders of the offspring, and it was unrelated to the age of the child at the diagnosis of diabetes or the age of the mother at delivery.
CONCLUSIONS These results suggest that an enterovirus infection during pregnancy is not a major risk factor for type 1 diabetes in childhood but may play a role in some susceptible subjects.
- Received December 8, 2011.
- Accepted February 14, 2012.
- © 2012 by the American Diabetes Association.
Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. See http://creativecommons.org/licenses/by-nc-nd/3.0/ for details.