Is Cardiovascular Mortality Related to the Season of Birth?

Reffelmann, Thorsten; Ittermann, Till; Empen, Klaus; Dörr, Marcus; Felix, Stephan B.

doi:10.1016/j.jacc.2010.10.021

Cited by 21 publications

(20 citation statements)

References 6 publications

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“…Prior evidence from the US,45 Sweden,67 Germany,89 Austria,1011 Denmark,1011 Australia,10 Lithuania,12 Japan,13 and Spain14 has related seasonal birth month effect to all cause and cardiovascular mortality in later life. Consistent with our current findings, two large longitudinal studies in Sweden (including over six million and four million people, respectively) with 20 years follow-up, reported the lowest cardiovascular mortality among participants born in November 67.…”

Section: Discussionmentioning

confidence: 99%

“…Later life familial and socioeconomic factors might also be associated with overall and cardiovascular mortality in adulthood 34. However, to our knowledge, none of these previous studies has been able to adequately control for these factors and other potential confounders,4567891011121314 limiting the interpretability of their findings 235…”

Section: Introductionmentioning

confidence: 96%

“…Previous studies have identified associations between season and month of birth and overall and cardiovascular disease related mortality in the United States,45 Sweden,67 Germany,89 Austria,1011 Denmark,1011 Australia,10 Lithuania,12 Japan,13 and Spain 14. Results from the northern hemisphere show relatively consistently that individuals born in November have the lowest risk of overall and cardiovascular mortality, whereas individuals born in the spring or summer (peaking in May) have the highest mortality risk 45678910111213. By contrast, in the southern hemisphere, the pattern of seasonal birth month effects on mortality seems to be shifted by half a year 10…”

Section: Introductionmentioning

confidence: 99%

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Birth month, birth season, and overall and cardiovascular disease mortality in US women: prospective cohort study

Yin

Devore

Strohmaier

et al. 2019

BMJ

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ObjectivesTo evaluate the associations between birth month, birth season, and overall and cardiovascular disease mortality, and to examine the role of familial and socioeconomic factors in these associations.DesignProspective cohort study.SettingNurses’ Health Study, established in 1976, an ongoing prospective cohort study in the United States.ParticipantsFemale registered nurses who reported information on date of birth at study enrolment (n=116 911, 1976-2014, followed for 38 years).ExposureBirth month and astronomical birth season (based on solstices and equinoxes as boundaries of the season categories).Main outcome measuresAge and various multivariable adjusted hazard ratios and 95% confidence intervals for the association between birth months (using November as the reference), astronomical birth season (using autumn as the reference), and overall and cardiovascular disease specific mortality were assessed using Cox proportional hazards models.ResultsAmong study participants, 43 248 overall deaths were documented during 4 136 364 person years of follow-up since enrolment, including 8360 cardiovascular disease related deaths. In fully adjusted multivariable analyses, no significant association was observed between birth month, birth season, and overall mortality. Compared with women born in November, increased cardiovascular disease mortality was observed among those born from March to July (hazard ratio for March, 1.09, 95% confidence interval 0.98 to 1.21; April, 1.12, 1.00 to 1.24; May, 1.08, 0.98 to 1.20; June, 1.07, 0.96 to 1.19; and July 1.08, 0.98 to 1.20). Those born in April had the highest cardiovascular disease mortality, and those born in December had the lowest (December, 0.95, 0.85 to 1.06). The relative difference between the lowest and highest risk month was 17.89%. Women born in spring (1.10, 1.04 to 1.17) and summer (1.09, 1.03 to 1.16) had a higher cardiovascular disease mortality than women born in the autumn. Adjustment for familial and socioeconomic factors did not change these results. The relative difference between the lowest and highest risk season was 10.00%.ConclusionParticipants born in the spring and summer (especially those born in March-July) had a slight but significant increase in cardiovascular disease specific mortality. However, no seasonal birth month effect was observed among women for overall mortality. Familial and socioeconomic factors did not appear to alter these associations. Further studies are required to confirm these findings and reveal mechanisms of these seasonal birth month effects in cardiovascular disease mortality.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 96%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Birth month, birth season, and overall and cardiovascular disease mortality in US women: prospective cohort study

Yin

Devore

Strohmaier

et al. 2019

BMJ

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“…These factors include not only meteorological factors and sunlight exposure, but also alterations in food supply and eating habits, energy expenditure (eg, outdoor physical activity and work load), air pollution, and exposure to infectious agents. 14 – 17 If factors responsible for programming early in life change seasonally, then it stands to reason that individuals who are born in various seasons are influenced by those factors differently. Therefore, the SoB may be related to the later-life phenotype.…”

Section: Introductionmentioning

confidence: 99%

The Associations of Month of Birth With Body Mass Index, Waist Circumference, and Leg Length: Findings From the China Kadoorie Biobank of 0.5 Million Adults

Guo

et al. 2015

Journal of Epidemiology

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BackgroundSeason of birth (SoB) has been linked with various health outcomes. This study aimed to examine the associations between month of birth (MoB) and adult measures of leg length (LL), body mass index (BMI), and waist circumference (WC).MethodsWe analysed survey data from 10 geographically diverse areas of China obtained through the China Kadoorie Biobank. Analysis included 487 529 adults with BMI ≥ 18.5 kg/m2. A general linear model was used to examine the associations between MoB and adult measures of LL, BMI, and WC, adjusted for survey site, sex, age, education level, smoking habit, alcohol consumption, physical activity level, sedentary leisure time, height (only for WC and LL), and hip circumference (only for LL).ResultsMoB was independently associated with both BMI and WC. Birth months in which participants had higher measures of adiposity were March–July for BMI and March–June for WC. The peak differences were 0.14 kg/m2 for BMI and 0.47 cm for WC. The association between MoB and LL depended on survey site. Participants who were born in February–August in four sites (Harbin, Henan, Gansu, and Hunan) had the shortest LL (all P < 0.01). The peak difference in mean LL was 0.21 cm. No statistically significant association between MoB and LL was noted in the other sites (Qingdao, Suzhou, Sichuan, Zhejiang, Liuzhou, and Haikou).ConclusionsThese findings suggest that MoB is associated with variations in adult adiposity measures and LL among Chinese adults. Low exposure to ultraviolet B radiation and subsequent reduced levels of vitamin D during the late second and early third trimesters may be involved in these phenomena.

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“…Most studies have only indirectly studied the influence of month of birth on mortality by cross-sectional reviews of death certificates from which average age at death has been calculated. [7], [9] To our knowledge, there is only one longitudinal population-based study that has investigated the association between month of birth and mortality. In a closed cohort, more than 1.3 million Danes aged 50 years or more were followed for 30 years.…”

Section: Introductionmentioning

confidence: 99%

Month of Birth and Mortality in Sweden: A Nation-Wide Population-Based Cohort Study

et al. 2013

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BackgroundMonth of birth – an indicator for a variety of prenatal and early postnatal exposures – has been associated with life expectancy in adulthood. On the northern hemisphere, people born in the autumn live longer than those born during the spring. Only one study has followed a population longitudinally and no study has investigated the relation between month of birth and mortality risk below 50 years.Methods and resultsIn this nation-wide Swedish study, we included 6,194,745 subjects, using data from population-based health and administrative registries. The relation between month of birth (January – December) and mortality risk was assessed by fitting Cox proportional hazard regression models using attained age as the underlying time scale. Analyses were made for ages >30, >30 to 50, >50 to 80 and >80 years. Month of birth was a significant predictor of mortality in the age-spans >30, >50 to 80, and >80 years. In models adjusted for gender and education for ages >30 and >50 to 80 years, the lowest mortality was seen for people born in November and the highest mortality in those born in the spring/summer, peaking in May for mortality >30 years (25‰ excess hazard ratio compared to November, [95% confidence interval = 16–34 ]) and in April for mortality >50 to 80 years (42‰ excess hazard ratio compared to November, [95% confidence interval = 30–55]). In the ages >80 years the pattern was similar but the differences in mortality between birth months were smaller. For mortality within the age-span >30 to 50 years, results were inconclusive.ConclusionMonth of birth is associated to risk of mortality in ages above 50 years in Sweden. Further studies should aim at clarifying the mechanisms behind this association.

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Is Cardiovascular Mortality Related to the Season of Birth?

Cited by 21 publications

References 6 publications

Birth month, birth season, and overall and cardiovascular disease mortality in US women: prospective cohort study

Birth month, birth season, and overall and cardiovascular disease mortality in US women: prospective cohort study

The Associations of Month of Birth With Body Mass Index, Waist Circumference, and Leg Length: Findings From the China Kadoorie Biobank of 0.5 Million Adults

Month of Birth and Mortality in Sweden: A Nation-Wide Population-Based Cohort Study

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