Journal Article

Maternal First-Trimester Enterovirus Infection and Future Risk of Type 1 Diabetes in the Exposed Fetus

Tapani Hovi, Pekka Vilja, Antti Reunanen, Heikki Hyöty, Pauli Leinikki, Jaakko Tuomilehto, Pentti Koskela, Karita Sadeharju, Merja Roivainen, Hanna R. Viskari, Janne Pitkäniemi

2002

Overview

Maternal First-Trimester Enterovirus Infection and Future Risk of Type 1 Diabetes in the Exposed Fetus Hanna R. Viskari 1 , Merja Roivainen 2 , Antti Reunanen 2 , Janne Pitkäniemi 2 , Karita Sadeharju 1 , Pentti Koskela 3 , Tapani Hovi 2 , Pauli Leinikki 2 , Pekka Vilja 1 , Jaakko Tuomilehto 2 4 and Heikki Hyöty 1 5 1 Juvenile Diabetes Foundation International Center for the Prevention of type 1 diabetes in Finland and the Department of Virology, University of Tampere, Medical School, Tampere, Finland 2 National Public Health Institute, Helsinki, Finland 3 National Public Health Institute, Oulu, Finland 4 Department of Public Health, University of Helsinki, Helsinki, Finland 5 Department of Clinical Microbiology, Centre for Laboratory Medicine, Tampere University Hospital, Tampere, Finland Abstract Previous studies have suggested that enterovirus infections during pregnancy may increase the risk of type 1 diabetes in the offspring. Our aim was to evaluate the role of first trimester enterovirus infections in a larger cohort of pregnant women. Two series of pregnant women were analyzed as follows: 948 women (series 1) and 680 women (series 2) whose child developed clinical diabetes before the ages of 15 or 7 years, respectively. An equal number of control women with a nondiabetic child was selected. Acute enterovirus infections were diagnosed by measuring IgM class antibodies against coxsackievirus B5 (series 1) and a mixture of coxsackievirus B3, coxsackievirus A16, and echovirus 11 antigens (series 2). In series 2, all sera were also analyzed for IgG class antibodies against an enterovirus peptide antigen. In addition, 152 randomly selected case-control pairs and all IgM-positive mothers’ sera were tested for enterovirus RNA (series 2). In series 1, 3.1% of case women had IgM antibodies against coxsackievirus B5 antigen compared with 4.1% of control women (NS). In series 2, 7.1% of case and 5.3% of control women had IgM against the mixture of enterovirus antigens (NS). IgG class enterovirus antibodies did not differ between the groups. Enterovirus RNA was found only in one case woman (0.3%) of the subgroup of samples and in 5.7% of 70 IgM-positive women. The results suggest that enterovirus infection during the first trimester of pregnancy is not associated with increased risk for type 1 diabetes in the child. Footnotes Address correspondence and reprint requests to Dr. Hanna Viskari, University of Tampere, Medical School/FM3, 5th floor, Department of Virology, Lenkkeilijänkatu 10, 33520 Tampere, Finland. E-mail: hanna.viskari{at}uta.fi . Received for publication 21 February 2002 and accepted in revised form 17 May 2002. CAV, coxsackievirus A; CBV, coxsackievirus B; EIA, enzyme immunoassay; EIU, enzyme immunoassay unit; RIA, radioimmunoassay. DIABETES

• Publisher: American Diabetes Association
• Subject: Age / Antibodies / Antibodies, Viral - blood / Antigens / Antigens, Viral - immunology / Biological and medical sciences / Children & youth / Diabetes / Diabetes Mellitus, Type 1 - epidemiology / Diabetes Mellitus, Type 1 - etiology / Diabetes. Impaired glucose tolerance / Endocrine pancreas. Apud cells (diseases) / Endocrinopathies / Enterovirus Infections - complications / Enteroviruses / Enzymes / Etiopathogenesis. Screening. Investigations. Target tissue resistance / Evaluation / Female / Fetal Diseases - epidemiology / Fetal Diseases - etiology / Fetal Diseases - virology / Fetus / Finland - epidemiology / Health aspects / Humans / Immunoassay / Immunoenzyme Techniques / Immunoglobulin M - blood / Incidence / Infection / Infections / Medical sciences / Mothers / Physiological aspects / Pregnancy / Pregnancy Complications, Infectious - virology / Pregnancy Trimester, First / Risk factors (Health) / RNA, Viral - blood / RNA, Viral - isolation & purification / Rubella / Type 1 diabetes / Viral Load