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Type 1 diabetes more likely in caesarean babies

28 August 2008

In Northern Ireland only around five in 1,000 children will develop type 1 diabetes by their 15th birthday, so a 20 percent increase is still quite a low risk.

Dr Chris Cardwell, study leader

Key facts
  • There are two types of diabetes – type 1 and type 2.
  • Type 1 diabetes happens when the body doesn’t produce the hormone insulin. It’s also known as insulin-dependent diabetes because people who have it need insulin injections.
  • Insulin is needed by the body to control sugar levels.
  • Type 1 diabetes is an autoimmune disorder. This means that it’s caused by the body’s own immune system destroying the cells that make insulin.
  • Caesarean delivery is an operation to deliver your baby through your abdomen (tummy). Some women need to have an emergency caesarean delivery, while others may plan to give birth to their baby this way.

Children born by caesarean section are 20 percent more likely to develop type 1 diabetes, according to a new review.

Researchers at Queen’s University in Belfast analysed the results of 20 studies to find out if there is a link between caesarean delivery and type 1 diabetes. They found that children delivered by caesarean section are at an increased risk of developing type 1 diabetes during childhood.

As well as the type of delivery, the researchers looked at other factors thought to increase the risk of a baby developing type 1 diabetes. These included birth weight, amount of time in the womb (gestation time), the age of the baby’s mother when she had the baby, whether or not she had diabetes during pregnancy and whether the baby was breastfed. None of these factors could explain the increase in type 1 diabetes in children delivered by caesarean.

Study leader Dr Chris Cardwell, emphasises that even with the 20 percent increase, the risk of a child developing type 1 diabetes is low.

“Type 1 diabetes is a fairly rare disease. In Northern Ireland only around five in 1,000 children will develop it by their 15th birthday, so a 20 percent increase is still quite a low risk”, he says.

It isn’t known why babies delivered by caesarean seem to have an increased risk of type 1 diabetes, but there are several theories. For example, being born by caesarean is thought to affect the bacteria that grow naturally in the baby’s gut because the baby is exposed to bacteria in the hospital rather than those from his/her mother. These bacteria play an important role in the development of a baby’s immune system, and changes to them may increase the risk of type 1 diabetes. Children delivered by caesarean section are also thought to be exposed to fewer infections in early life, which could increase their risk of type 1 diabetes.

Dr Cardwell says we can’t jump to conclusions about the results.

“Caesarean section itself may be responsible for the increased risk. But we can't rule out other unknown factors that are more likely in children delivered by caesarean, which could also be the cause.”

“So, the 20 percent increase in the risk of type 1 diabetes after caesarean section shouldn’t be over-emphasised”, he adds.

The researchers say that more studies are needed.

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