Cesarean Section and Genes Combine to Increase Childhood T1D Risk

This research studied the associations between cesarean delivery, islet autoimmunity and T1D, and genes involved in T1D susceptibility. The study was performed in children from the BABYDIAB study, a longitudinal study examining the natural history of islet autoimmunity and T1D in 1,650 children born to a mother or father with T1D. The risk for developing T1D by age 12 years was higher in children who were delivered by cesarean section than children born by vaginal delivery. Furthermore, the rate of progression from the development of islet autoantibodies to overt T1D in autoantibody positive children was higher in children delivered by cesarean section versus children born by vaginal delivery. Finally, the investigators examined genotypes of four gene regions for association with T1D and for possible interactions with cesarean section in the association with T1D risk. The data showed an interaction between cesarean section and certain T1D susceptible immune response genes, suggesting that cesarean section could affect the risk for T1D by modifying the hosts environment and immune response.

Reference:

Bonifacio E, Warncke K, Winkler C, Wallner M, Ziegler AG., (2011) Cesarean section and interferon-induced helicase gene polymorphisms combine to increase childhood type 1 diabetes risk. Diabetes. Dec;60(12):3300-6.

Ramifications for Individuals with Type 1 Diabetes:

This study supports an association between birth delivery method and T1D showing that cesarean section increases the risk for the progression to T1D after the initiation of islet autoimmunity, and this increased risk appears to be influenced by environment response genes. The important goal moving forward will be to explore possible ways to interfere with the progression to T1D in those children identified at-risk or in those who already have islet autoantibodies.

JDRF Involvement:

JDRF funded this study.