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However, there is limited information on risk patterns across the full range of gestational ages, especially after extremely preterm birth (23\u201327 weeks of gestation). We investigated the risk of type 1 diabetes in childhood and young adulthood across the full range of length of gestation at birth.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Data were obtained from national registers in Finland, Norway and Sweden. In each country, information on study participants and gestational age was collected from the Medical Birth Registers, information on type 1 diabetes diagnoses was collected from the National Patient Registers, and information on education, emigration and death was collected from the respective national register sources. Individual-level data were linked using unique personal identity codes. The study population included all individuals born alive between 1987 and 2016 to mothers whose country of birth was the respective Nordic country. Individuals were followed until diagnosis of type 1 diabetes, death, emigration or end of follow-up (31 December 2016 in Finland, 31 December 2017 in Norway and Sweden). Gestational age was categorised as extremely preterm (23\u201327 completed weeks), very preterm (28\u201331 weeks), moderately preterm (32\u201333 weeks), late preterm (34\u201336 weeks), early term (37\u201338 weeks), full term (39\u201341 weeks; reference) and post term (42\u201345 weeks). HRs and 95% CIs from country-specific covariate-adjusted Cox regression models were combined in a meta-analysis using a common-effect inverse-variance model.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Among 5,501,276 individuals, 0.2% were born extremely preterm, 0.5% very preterm, 0.7% moderately preterm, 4.2% late preterm, 17.7% early term, 69.9% full term, and 6.7% post term. A type 1 diabetes diagnosis was recorded in 12,326 (0.8%), 6364 (0.5%) and 16,856 (0.7%) individuals at a median age of 8.2, 13.0 and 10.5 years in Finland, Norway and Sweden, respectively. Individuals born late preterm or early term had an increased risk of type 1 diabetes compared with their full-term-born peers (pooled, multiple confounder-adjusted HR 1.12, 95% CI 1.07, 1.18; and 1.15, 95% CI 1.11, 1.18, respectively). However, those born extremely preterm or very preterm had a decreased risk of type 1 diabetes (adjusted HR 0.63, 95% CI 0.45, 0.88; and 0.78, 95% CI 0.67, 0.92, respectively). These associations were similar across all three countries.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions\/interpretation<\/jats:title>\n                <jats:p>Individuals born late preterm and early term have an increased risk of type 1 diabetes while individuals born extremely preterm or very preterm have a decreased risk of type 1 diabetes compared with those born full term.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Graphical Abstract<\/jats:title>\n                \n              <\/jats:sec>","DOI":"10.1007\/s00125-024-06139-y","type":"journal-article","created":{"date-parts":[[2024,4,13]],"date-time":"2024-04-13T05:01:52Z","timestamp":1712984512000},"page":"1315-1327","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Gestational age at birth and type 1 diabetes in childhood and young adulthood: a nationwide register study in Finland, Norway and Sweden"],"prefix":"10.1007","volume":"67","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3806-1020","authenticated-orcid":false,"given":"Johanna","family":"Mets\u00e4l\u00e4","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6599-0146","authenticated-orcid":false,"given":"Kari","family":"Risnes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2268-3159","authenticated-orcid":false,"given":"Martina","family":"Persson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6557-270X","authenticated-orcid":false,"given":"Riitta","family":"Veijola","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0602-8632","authenticated-orcid":false,"given":"Anna","family":"Pulakka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6269-6881","authenticated-orcid":false,"given":"Katriina","family":"Heikkil\u00e4","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4010-5299","authenticated-orcid":false,"given":"Suvi","family":"Alenius","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8254-7525","authenticated-orcid":false,"given":"Mika","family":"Gissler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6593-8433","authenticated-orcid":false,"given":"Signe","family":"Opdahl","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6994-4884","authenticated-orcid":false,"given":"Sven","family":"Sandin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7081-8391","authenticated-orcid":false,"given":"Eero","family":"Kajantie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,4,13]]},"reference":[{"issue":"3","key":"6139_CR1","doi-asserted-by":"publisher","first-page":"226","DOI":"10.1016\/S2213-8587(19)30412-7","volume":"8","author":"JM Norris","year":"2020","unstructured":"Norris JM, Johnson RK, Stene LC (2020) Type 1 diabetes-early life origins and changing epidemiology. 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Access to the Finnish data can be requested from the Finnish Social and Health Data Permit Authority (Findata; ). Access to the Norwegian data can be requested from the Norwegian Health Data service () and Statistics Norway () but requires ethical approval and institutional data protection assessment. Access to the Swedish data can be requested from the National Board of Health and Welfare () and Statistics Sweden ().","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Data availability"}},{"value":"This work has received funding from the European Union Horizon 2020 research and innovation programme under grant agreement no 733280 for Research on European Children and Adults Born Preterm (RECAP). JM was funded by the Finnish Cultural Foundation. EK was funded by the Academy of Finland (315690), Foundation for Pediatric Research, Novo Nordisk Foundation, Sigrid Jus\u00e9lius Foundation, Signe and Ane Gyllenberg Foundation, Finska L\u00e4kares\u00e4llskapet and Yrj\u00f6 Jahnsson Foundation. MP had a Stockholm City Council research position. AP was funded by the European Commission through Horizon 2020 (874739) and Horizon Europe (101057739). KH was funded by the Foundation for Pediatric Research and Signe and Ane Gyllenberg Foundation. The Joint Research Committee of St Olav\u2019s University Hospital and the Faculty of Medicine and Health Sciences at the Norwegian University of Science and Technology (NTNU) funded Norwegian contributions to this study (30223\/2022). Funders had no role in the design of the study, analysis of the data, reporting of the results or the decision to submit the manuscript for publication.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Funding"}},{"value":"The authors declare that there are no relationships or activities that might bias, or be perceived to bias, their work.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Authors\u2019 relationships and activities"}},{"value":"JM generated the hypotheses and designed the study, with input from KR, SS, MP and EK. KR, SS and EK led on data acquisition and secured funding. JM, KH, AP and SO participated in generating analytical datasets and JM analysed the data. All authors participated in interpretation of data. JM drafted the manuscript and all authors critically revised it for important intellectual content. JM had full access to the data from all countries and KR, SO, SS, KH, AP and EK had full access to the data from their respective countries. All authors take final responsibility for the decision to submit the report for publication. EK is the guarantor of this work.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Contribution statement"}}]}}