Mother's weight in pregnancy and coronary heart disease in a cohort of Finnish men: Follow up study
Mother's weight in pregnancy and coronary heart disease in a cohort of Finnish men: Follow up study
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DOI：
10.1136/bmj.315.7112.837
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发表时间：
1997-10-04
影响因子：
--
通讯作者：
Barker, DJP
中科院分区：
文献类型：
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作者：
Forsen, T;Eriksson, JG;Barker, DJP
目的：为了确定在芬兰男性中子宫内生长受限是否与冠心病风险增加相关，芬兰男性冠心病的发病率是世界上最高的。设计：随访研究。地点：芬兰赫尔辛基。受试者：1924年出生于赫尔辛基大学中心医院的3302名男性-33人在赫尔辛基市上学，1971年居住在芬兰。主要结果测量：冠心病的标准化死亡率。母亲怀孕期间体重指数高的男性死亡率也很高。在多变量分析中，出生时体重指数每降低一个标准差，冠心病的危险比为1.37（95%置信区间1.20 ~ 1.57）（P < 0.0001），母亲体重指数每增加一个标准差，冠心病的危险比为1.24（1.10 ~ 1.39）（P = 0.0004）。母亲的身体质量指数的影响仅限于母亲低于平均stigation.Conclusion：这些研究结果表明，伴随西化的冠心病的流行病的一个新的解释。长期营养不良的妇女又矮又轻，她们的婴儿往往很瘦。改善营养的直接影响是女性变胖，这似乎会增加下一代患冠心病的风险。随着营养状况的不断改善，妇女变得更高、更重;她们的婴儿得到充分的营养;母亲肥胖不再增加患冠心病的风险，从而降低了患冠心病的风险。
Objective: To determine whether restricted growth in utero is associated with an increased risk of coronary heart disease among men in Finland, where rates of the disease are among the highest in the world.Design: Follow up study.Setting: Helsinki, Finland.Subjects: 3302 men born in Helsinki University Central Hospital during 1924-33 who went to school in the city of Helsinki and were resident in Finland in 1971.Main outcome measures: Standardised mortality ratios for coronary heart disease.Results: Men who were thin at birth, with low placental weight, had high death rates from coronary heart disease. Men whose mothers had a high body mass index in pregnancy also had high death rates. In a multivariate analysis the hazard ratio for coronary heart disease was 1.37 (95% confidence interval 1.20 to 1.57) (P < 0.0001) for every standard deviation decrease in ponderal index at birth and 1.24 (1.10 to 1.39) (P = 0.0004) for every standard deviation increase in mother's body mass index. The effect of mother's body mass index was restricted to mothers of below average stature.Conclusion: These findings suggest a new explanation for the epidemics of coronary heart disease that accompany Westernisation. Chronically malnourished women are short and light and their babies tend to be thin. The immediate effect of improved nutrition is that women become fat, which seems to increase the risk of coronary heart disease in the next generation. With continued improvements in nutrition, women become taller and heavier; their babies are adequately nourished; and maternal fatness no longer increases the risk of coronary heart disease, which therefore declines.