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American Journal of Epidemiology Advance Access published online on January 10, 2007
American Journal of Epidemiology, 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).

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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