Longitudinal study of birth weight and adult body mass index in predicting risk of coronary heart disease and stroke in women

Abstract

Objectives To determine whether birth weight and adult body size interact to predict coronary heart disease in women, as has been observed for men. To determine whether birth weight and adult body size interact to predict risk of stroke. Design Longitudinal cohort study. Setting and participants 66 111 female nurses followed since 1976 who were born of singleton, term pregnancies and reported their birth weight in 1992. Main outcome measures 1504 events of coronary heart disease (myocardial infarction or sudden cardiac death) and 1164 strokes. Results For each kilogram of higher birth weight, age adjusted hazard ratios from prospective analysis were 0.77 (95% confidence interval 0.69 to 0.87) for coronary heart disease and 0.89 (0.78 to 1.01) for total stroke. In combined prospective and retrospective analysis, hazard ratios were 0.84 (0.76 to 0.93) for total stroke, 0.83 (0.71 to 0.96) for ischaemic stroke, and 0.86 (0.66 to 1.11) for haemorrhagic stroke. Exclusion of macrosomic infants ( > 4536 g) yielded stronger estimates. Risk of coronary heart disease was especially high for women who crossed from a low centile of weight at birth to a high centile of body mass index in adulthood. The association of lower birth weight with increased risk of stroke was apparent across categories of body mass index in adults and was not especially strong among heavier women. Conclusions Higher body mass index in adulthood is an especially strong risk factor for coronary heart disease among women who were small at birth. In this large cohort of women, size at birth and adiposity in adulthood interacted to predict events of coronary heart disease but not stroke events.

Small for gestational age status is associated with metabolic syndrome in overweight children

“…The association between SGA status and hypertriglyceridemia, hypertension, and impaired glucose metabolism is in concordance with previous studies (7,(26)(27)(28). However, waist circumference and HDL cholesterol levels as major components of the MetS were not related to SGA status in our study of overweight children.…”

BMI Screening and Surveillance: An International Perspective

“…Similar results are now evident in many countries including the United States, 24 Guatemala, Finland, China, and India. If the children are of low birth weight (LBW), then as shown in our Millennium analyses for the United Nations, 25 their likelihood of being underweight for age in the first few years of life is exceptionally high, because children would have to show accelerated growth from birth to be classified otherwise.…”

Prospective study of body size and risk for stroke amongst women below age 60

“…There are few published studies on this subject, with contradictory results. One study found that each additional kilogram of birth weight was associated with a 11% decreased risk of stroke, with the exception of macrosomic infants [20]. In another cohort of women and men from Sweden, each kilogram increase in birth weight was associated with a 41% decreased risk of haemorrhagic stroke [21].…”