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Birthweight and the Risk for Type 2 Diabetes Mellitus in Adult Women
- Janet W. Rich-Edwards, DSc;
- Graham A. Colditz, MBBS;
- Meir J. Stampfer, MD;
- Walter C. Willett, MD;
- Matthew W. Gillman, MD;
- Charles H. Hennekens, MD;
- Frank E. Speizer, MD; and
- JoAnn E. Manson, MD
Abstract
Background: Previous reports have suggested an association between birthweight and type 2 diabetes mellitus.
Objective: To investigate the association between birthweight and type 2 diabetes in a large cohort of adult women, taking into account potential explanatory factors in childhood and adult life.
Design: Cohort study. Birthweight was ascertained at the end of follow-up.
Setting: The Nurses' Health Study, a cohort of 121 701 U.S. women born from 1921 to 1946 who have been followed since 1976.
Participants: 69 526 women in the Nurses' Health Study who were free of diabetes at baseline and reported their own birthweight on the 1992 questionnaire.
Measurement: 2123 cases of confirmed type 2 diabetes diagnosed from 1976 to 1992.
Results: Low birthweight was associated with increased risk for type 2 diabetes. Age-adjusted relative risks suggested a reverse J-shape association between birthweight and risk for type 2 diabetes. However, after adjustment for adult body mass index and maternal history of diabetes, an inverse association across the entire range of birthweight became apparent; compared with the reference group, relative risks by ascending birthweight category were 1.83 (95% CI, 1.55 to 2.16) for birthweight less than 5.0 lb, 1.76 (CI, 1.49 to 2.07) for birthweight 5.0 to 5.5 lb, 1.23 (CI, 1.11 to 1.37) for birthweight 5.6 to 7.0 lb, 0.95 (CI, 0.82 to 1.10) for birthweight 8.6 to 10.0 lb, and 0.83 (CI, 0.63 to 1.07) for birthweight of more than 10 lb (P for trend < 0.001). Adjustment for ethnicity, childhood socioeconomic status, and adult lifestyle factors did not substantially alter this association. The association between birthweight and risk for type 2 diabetes was strongest among women whose mothers had no history of diabetes.
Conclusions: Birthweight is inversely associated with risk for type 2 diabetes during adulthood. Examination of prenatal nutrition and other potential in utero determinants of both birthweight and risk for type 2 diabetes may yield new means to prevent type 2 diabetes.
- Birth weight
- Diabetes mellitus, non-insulin-dependent
- Infant, low birth weight
- Body weight
- Diabetes, gestational
Article and Author Information
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Acknowledgments: The authors thank the participants in the Nurses' Health Study for their dedication and Gary Chase, Karen Corsano, Barbara Egan, Maureen Johnston, and Mark Shneyder for their excellent work.
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Grant Support: The Nurses' Health Study is supported by research grants DK36798 and CA 40356 from the National Institutes of Health.
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Requests for Reprints: Janet W. Rich-Edwards, DSc, Nurses' Health Study, Channing Laboratory, 181 Longwood Avenue, Boston, MA 02115.
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Current Author Addresses: Drs. Rich-Edwards and Gillman: Department of Ambulatory Care and Prevention, 126 Brookline Avenue, Suite 200, Boston, MA 02115.
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Drs. Colditz, Stampfer, Willett, Speizer, and Manson: Nurses' Health Study, Channing Laboratory, 181 Longwood Avenue, Boston, MA 02115.
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Dr. Hennekens: Division of Preventive Medicine, Brigham and Women's Hospital, 900 Commonwealth Avenue East, Boston, MA 02215.
- Copyright ©2004 by the American College of Physicians
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