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

D. A. Lawlor, G. Ronalds, Heather Clark, G. Davey-Smith, D. A. Leon

Research output: Contribution to journalArticle

181 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)1414-1418
Number of pages4
JournalCirculation
Volume112
DOIs
Publication statusPublished - Aug 2005

Keywords

  • cerebrovascular disorders
  • coronary disease
  • epidemiology
  • birth weight
  • SYSTOLIC BLOOD-PRESSURE
  • CATCH-UP GROWTH
  • FETAL-GROWTH
  • CARDIOVASCULAR-DISEASE
  • SWEDISH MEN
  • LATER LIFE
  • WOMEN
  • DEATH
  • RISK
  • SIZE

Cite this

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. / Lawlor, D. A.; Ronalds, G.; Clark, Heather; Davey-Smith, G.; Leon, D. A.

In: Circulation, Vol. 112, 08.2005, p. 1414-1418.

Research output: Contribution to journalArticle

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title = "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",
abstract = "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.",
keywords = "cerebrovascular disorders, coronary disease, epidemiology, birth weight, SYSTOLIC BLOOD-PRESSURE, CATCH-UP GROWTH, FETAL-GROWTH, CARDIOVASCULAR-DISEASE, SWEDISH MEN, LATER LIFE, WOMEN, DEATH, RISK, SIZE",
author = "Lawlor, {D. A.} and G. Ronalds and Heather Clark and G. Davey-Smith and Leon, {D. A.}",
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TY - JOUR

T1 - 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

AU - Lawlor, D. A.

AU - Ronalds, G.

AU - Clark, Heather

AU - Davey-Smith, G.

AU - Leon, D. A.

PY - 2005/8

Y1 - 2005/8

N2 - 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.

AB - 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.

KW - cerebrovascular disorders

KW - coronary disease

KW - epidemiology

KW - birth weight

KW - SYSTOLIC BLOOD-PRESSURE

KW - CATCH-UP GROWTH

KW - FETAL-GROWTH

KW - CARDIOVASCULAR-DISEASE

KW - SWEDISH MEN

KW - LATER LIFE

KW - WOMEN

KW - DEATH

KW - RISK

KW - SIZE

U2 - 10.1161/CIRCULATIONAHA.104.528356

DO - 10.1161/CIRCULATIONAHA.104.528356

M3 - Article

VL - 112

SP - 1414

EP - 1418

JO - Circulation

JF - Circulation

SN - 0009-7322

ER -