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American Journal of Epidemiology Advance Access originally published online on January 10, 2007
American Journal of Epidemiology 2007 165(8):849-857; doi:10.1093/aje/kwk071
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American Journal of Epidemiology Copyright © 2007 by the Johns Hopkins Bloomberg School of Public Health All rights reserved; printed in U.S.A.

Birth Weight and Subsequent Risk of Type 2 Diabetes: A Meta-Analysis

Thomas Harder, Elke Rodekamp, Karen Schellong, Joachim W. Dudenhausen and Andreas Plagemann

From the Obstetrics Clinic, "Experimental Obstetrics" Research Group, Charité–University Medicine Berlin, Campus Virchow-Klinikum, Berlin, Germany

Reprint requests to Dr. Thomas Harder, "Experimental Obstetrics" Research Group, Charité–University Medicine Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353 Berlin, Germany (e-mail: thomas.harder{at}charite.de).

Received for publication June 22, 2006. Accepted for publication September 20, 2006.

The "small baby syndrome hypothesis" suggests that an inverse linear relation exists between birth weight and risk of type 2 diabetes. The authors conducted a meta-analysis to examine this association. They included studies that reported odds ratios and 95% confidence intervals (or data with which to calculate them) for the association of type 2 diabetes with birth weight. Fourteen studies involving a total of 132,180 persons were identified. Low birth weight (<2,500 g), as compared with a birth weight of ≥2,500 g, was associated with increased risk of type 2 diabetes (odds ratio (OR) = 1.32, 95% confidence interval (CI): 1.06, 1.64). High birth weight (>4,000 g), as compared with a birth weight of ≤4,000 g, was associated with increased risk to the same extent (OR = 1.27, 95% CI: 1.01, 1.59). Pooled estimates increased further when normal birth weight (2,500–4,000 g) was used as the reference category (low birth weight: OR = 1.47, 95% CI: 1.26, 1.72; high birth weight: OR = 1.36, 95% CI: 1.07, 1.73). Meta-regression and categorical analyses showed a U-shaped relation between birth weight and diabetes risk. These findings indicate that there exists a relation between birth weight and later-life risk of type 2 diabetes which is not linearly inverse but U-shaped.

birth weight; diabetes mellitus, type 2; meta-analysis

Abbreviations: CI, confidence interval; OR, odds ratio


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