Birth weight is inversely associated with incident coronary heart disease and stroke among individuals born in the 1950s - Findings from the Aberdeen children of the 1950s prospective cohort study
Birth weight is inversely associated with incident coronary heart disease and stroke among individuals born in the 1950s - Findings from the Aberdeen children of the 1950s prospective cohort study
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DOI：
10.1161/circulationaha.104.528356
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发表时间：
2005-09-06
期刊：
影响因子：
37.8
通讯作者：
Leon, DA
中科院分区：
文献类型：
--
作者：
Lawlor, DA;Ronalds, G;Leon, DA
背景-出生体重与心血管疾病危险因素呈负相关，但很少有研究检查与疾病终点的关系，特别是与中风风险的关系。此外，以前的研究表明，出生体重和冠心病（CHD）风险之间的负相关性已经在出生于婴儿死亡率高的20世纪世纪早期的人群中进行。如果环境因素与上个世纪婴儿死亡率的改善有关，可以解释出生体重与冠心病风险之间的负相关关系，方法和结果--我们在一个10803人的大型出生队列中研究了这种关联，（平均随访239000人年）1950年至1956年期间发生的单胎分娩。我们的结果是CHD（n = 296）和卒中（n = 107）的住院率和死亡率。出生体重与冠心病和中风呈负相关。出生体重增加1 kg的年龄校正风险比，CHD为0.62（95%CI 0.50 - 0.78），卒中为0.38（95%CI 0.24 - 0.60）。校正胎龄、出生时的社会阶层、入学时的身高和体重指数、妊娠、母亲出生时的年龄、妊娠高血压、产前出血和母亲身高并没有改变与CHD的相关性，但将与卒中的相关性减弱至0.48（95%CI 0.30 - 0.76）。这种衰减主要是由于胎龄调整造成的，胎龄与中风风险呈线性负相关。性别和胎龄标准化新生儿体重z评分校正后的危险比为0.85（95% CI 0.73 - 0.97），CHD和0.74（95%CI 0.71至0.88）中风。结论-出生体重与CHD和中风呈负相关，出生时的环境条件，如婴儿死亡率低，对婴儿相对有利。
Background - Birth weight is inversely associated with cardiovascular disease risk factors, but few studies have examined the association with disease end points, in particular with stroke risk. Furthermore, previous studies demonstrating an inverse association between birth weight and coronary heart disease (CHD) risk have been conducted on populations born in the early part of the 20th century, when infant mortality rates were high. If the environmental factors associated with improvements in infant mortality rates over the last century explain the inverse association between birth weight and CHD risk, one would expect weaker associations in more contemporary birth cohorts.Methods and Results - We have examined the association in a large birth cohort of 10 803 ( with an average of 239 000 person-years of follow-up) singleton births that occurred between 1950 and 1956. Our outcomes were hospital admissions for, and fatalities from, CHD (n = 296) and stroke (n = 107). Birth weight was inversely associated with CHD and stroke. The age-adjusted hazards ratio for a 1-kg increase in birth weight was 0.62 (95% CI 0.50 to 0.78) for CHD and 0.38 (95% CI 0.24 to 0.60) for stroke. Adjustment for gestational age, social class at birth, height and body mass index at school entry, gravidity, maternal age at birth, pregnancy-induced hypertension, antepartum hemorrhage, and maternal height did not alter the association with CHD but attenuated the association with stroke to 0.48 (95% CI 0.30 to 0.76). This attenuation resulted largely from adjustment for gestational age, which was linearly inversely related to stroke risk. Adjusted hazard ratios per sex and gestational age standardized z score of birth weight were 0.85 (95% CI 0.73 to 0.97) for CHD and 0.74 (95% CI 0.71 to 0.88) for stroke.Conclusions - Birth weight is inversely associated with CHD and stroke in a population born at a time when environmental circumstances, as indexed by low infant mortality rates, were relatively advantageous for infants.