Background: The incidence of both; premature infants survival and type 1 diabetes (T1D) increases worldwide.
Aim: to assess the association between nutritional, antibiotic and parenteral exposures during the neonatal period and pediatric T1D.
Methods: a multicenter, paired case-control study. Preterm subjects who developed T1D before the age of 18 years (T1D group) were paired with subjects who didn`t develop TID (Control group) by: gender, gestational age (GA), month and birth medical center. Data included delivery mode, ethnicity, weight, length of hospitalization, medications, parenteral fluid, feeding modes and timing.
Results: In univariate analysis, the odds ratio (OR) for T1D increased with each extra 100 grams in BW (OR 1.13, 95%CI 1.057-1.206, p < 0.001), later day of parenteral glucose initiation (OR 1.61, 95%CI 1.05-2.48, p 0.03), and parenteral cephalosporines initiated beyond the first week of life (OR 3.25, 95%CI 1.504-7.04, p 0.003). Multivariate analysis revealed significant association between both treatment with cephalosporins beyond the first week of life and later day of parenteral glucose initiation and the development of pediatric T1D (OR 6.49, 95%CI 1.54-27.44, p 0.011 and OR 1.61, 95%CI 1.05-2.48, p 0.002, respectively). No association with feeding modality, timing and type of feeding was found.
Conclusions: This is the first report indicating significant association between parenteral exposure and timing of antibiotic treatments and glucose solution administration during the neonatal period with T1D. This indicates the need for a larger study to conclude clinical implications of exposure to these substances during the neonatal period.
