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We reviewed the association between virus infections in pregnant women and development of islet autoimmunity or type 1 diabetes in their offspring. We performed a systematic review and meta\u2010analysis, analysed using random effects models, of human studies from Medline and EMBASE without language restriction. Inclusion criteria were as follows: cohort and case\u2010control studies measuring viral nucleic acid in blood, stool, urine, or tissue, or serological tests for viruses, in pregnant women whose offspring developed islet autoimmunity and\/or type 1 diabetes. All studies required sufficient data to calculate odds ratios and 95% confidence intervals. The 10 studies (4 case control, 6 nested\u2010case control) that met the eligibility criteria included 2992 participants (953 offspring, 2039 mothers), with varying study design. The 2 outcomes examined were islet autoimmunity (<jats:italic>n<\/jats:italic>\u00a0=\u00a0466) and type 1 diabetes (<jats:italic>n<\/jats:italic>\u00a0=\u00a02526). Meta\u2010analysis showed a significant association between virus infection during pregnancy and clinical type 1 diabetes during childhood (odds ratio 2\u00b716, 95% CI 1\u00b722\u20103\u00b780; <jats:italic>P<\/jats:italic>\u00a0=\u00a00\u00b7008; heterogeneity <jats:italic>X<\/jats:italic><jats:sup>2<\/jats:sup>\u00a0=\u00a01\u00b765, <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>\u00a0=\u00a040%), but no association with islet autoimmunity (1\u00b745, 0\u00b763\u20103\u00b731; <jats:italic>P<\/jats:italic>\u00a0=\u00a00\u00b738; <jats:italic>X<\/jats:italic><jats:sup>2<\/jats:sup>\u00a0=\u00a01\u00b734, <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>\u00a0=\u00a025%). The increased risk of type 1 diabetes following maternal virus infection is consistent with viraemia involving the fetus during pregnancy and suggests a potential causative link between antenatal infection and type 1 diabetes. Larger prospective birth studies with more frequent sampling, and pathogenesis studies, are required to more clearly establish an aetiological link.<\/jats:p>","DOI":"10.1002\/rmv.1974","type":"journal-article","created":{"date-parts":[[2018,3,23]],"date-time":"2018-03-23T07:23:38Z","timestamp":1521789818000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":63,"title":["Maternal virus infections in pregnancy and type 1 diabetes in their offspring: Systematic review and meta\u2010analysis of observational studies"],"prefix":"10.1002","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0243-4948","authenticated-orcid":false,"given":"Digby W.","family":"Allen","sequence":"first","affiliation":[{"name":"School of Women's and Children's Health University of New South Wales Medicine  Sydney Australia"},{"name":"POWH and UNSW Virology Research Laboratory Prince of Wales Hospital  Sydney Australia"},{"name":"School of Medical Sciences, Faculty of Medicine University of New South Wales  Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9579-6408","authenticated-orcid":false,"given":"Ki Wook","family":"Kim","sequence":"additional","affiliation":[{"name":"School of Women's and Children's Health University of New South Wales Medicine  Sydney Australia"},{"name":"POWH and UNSW Virology Research Laboratory Prince of Wales Hospital  Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0988-7827","authenticated-orcid":false,"given":"William D.","family":"Rawlinson","sequence":"additional","affiliation":[{"name":"School of Women's and Children's Health University of New South Wales Medicine  Sydney Australia"},{"name":"POWH and UNSW Virology Research Laboratory Prince of Wales Hospital  Sydney Australia"},{"name":"School of Medical Sciences, Faculty of Medicine University of New South Wales  Sydney Australia"},{"name":"School of Biotechnology and Biomolecular Science, Faculty of Science University of New South Wales  Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6004-576X","authenticated-orcid":false,"given":"Maria E.","family":"Craig","sequence":"additional","affiliation":[{"name":"School of Women's and Children's Health University of New South Wales Medicine  Sydney Australia"},{"name":"POWH and UNSW Virology Research Laboratory Prince of Wales Hospital  Sydney Australia"},{"name":"School of Medical Sciences, Faculty of Medicine University of New South Wales  Sydney Australia"},{"name":"Institute of Endocrinology and Diabetes The Children's Hospital at Westmead  Sydney Australia"},{"name":"Discipline of Child and Adolescent Health, The Children's Hospital at Westmead Clinical School The University of Sydney  Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,3,22]]},"reference":[{"key":"e_1_2_12_2_1","unstructured":"International Diabetes Federation. 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