Birth weight and risk of coronary heart disease in adults: a meta-analysis of prospective cohort studies

Abstract

Some studies have found a significant relationship between birth weight (BW) and the risk of coronary heart disease (CHD) in adulthood, but results were inconsistent. The purpose of this study was to characterize the association between BW and the risk of CHD in adults. Among 144 papers detected by our search, 27 papers provided data on the relationship between BW and CHD, of which 23 papers considered BW as a continuous variable, and 14 articles considered BW as a categorical variable for this meta-analysis. Based on 23 papers, the mean weighted estimate for the association between BW and the combined outcome of non-fatal and fatal CHD was 0.83 [95% confidence interval (CI), 0.80-0.86] per kilogram of BW (P<0.0001). Low birth weight (LBW<2500 g) was associated with increased risk of CHD [odds ratio (OR), 1.19; 95% confidence interval (CI), 1.11-1.27] compared with subjects with BW⩾2500 g. LBW, as compared with normal BW (2500-4000 g), was associated with increased risk of CHD (OR, 1.16; 95% CI, 1.08-1.25). High birth weight (HBW⩾4000 g) was associated with decreased risk of CHD (OR, 0.89; 95% CI, 0.81-0.98) compared with subjects with BW<4000 g. In addition, there was an indication (not quite significant) that HBW was associated with a lower risk of CHD (OR, 0.89; 95% CI, 0.79-1.01), as compared with normal BW. No significant evidence of publication bias was present. These results suggest that LBW is significantly associated with increased risk of CHD and a 1 kg higher BW is associated with a 10-20% lower risk of CHD.

Birth weight and risk of ischemic heart disease: A Mendelian randomization study

“…This novel study using Mendelian randomization, a potentially less confounded study design, is consistent with previous meta-analysis of observational studies suggesting that lower birth weight may be associated with a slightly higher risk of IHD1819. Our study also adds by showing a similar estimate of the effect of lower birth weight on MI.…”

“…Our findings also do not exclude a small inverse association of birth weight with IHD of a fairly similar magnitude to those found in meta-analysis of observational studies1819, although Mendelian randomizations estimates may be inflated by imprecise measurement of the exposure27. On the other hand, we cannot exclude no association but twins usually have lower birth weight but not a different risk of cardiovascular disease from their siblings28.…”

Body size at birth and coronary heart disease-related hospital care in adult men – findings from the Helsinki Birth Cohort Study

“…(1,2,3) This association, which is likely to result from suboptimal prenatal conditions, such as lack of nutrients at particular stages of gestation, also known as sensitive periods (4) or variation in the normal placental development. (5) These conditions may cause long-lasting changes in the developing organ structures and functioning of biological systems placing an individual at risk for negative health outcomes in adulthood.…”

Opportunities During Early Life for Cancer Prevention: Highlights From a Series of Virtual Meetings With Experts

“…For example, experts noted that the prevalence of the given risk factor and the association (positive or negative) with other health outcomes 15 are important to consider (eg, the inverse association between birth weight and risk of cardiovascular disease 93 ). When deciding whether to implement specific intervention or prevention strategies, both the short- and long-term effects, including potential unintended consequences or drawbacks to taking action (eg, harmful effects on other health outcomes), need to be considered.…”

“…For example, high birth weight appears to be associated with an increased risk of certain pediatric and adult cancers, 22,26 but evidence also suggests that high birth weight may also be associated with a reduced risk of heart disease. 93 …”