P2-274 Trend of maternal mortality rate in Iran from 1970 to 2007; a systematic review and meta-analysis

Abstract

Hong Kong Chinese population experienced abrupt macro-environmental change generated by mass migration in the late 1940s from pre-industrial China to economically developing Hong Kong. We took advantage of this natural experiment to test whether a "stepchange" in living conditions in early life had sex-specific cohort effects on IHD mortality. Methods We used sex-specific age-period-cohort models to identify cohort effects in adult IHD mortality from 1976 to 2005 overall and by migrant status. To check for specificity, we examined mortality from lung cancer and renal diseases. Results Birth cohort effects varied with sex, with a marked upturn in IHD mortality for the first generation of men born into the comparatively developed environment of Hong Kong. The upturn occurred first in non-migrants and later in migrants. There were no such upturns in women or such sex-specific changes for lung cancer or renal diseases. Conclusion Men's vulnerability to premature IHD may be actuated in early life, perhaps mediated by inter-generationally and nutritionally driven levels of pubertal sex-steroids. This has considerable public health implications for the large population of young males in countries undergoing rapid economic transition. .0% for adult and by 4.2 and 5.6% for old men and women respectively. For population of working age, these trends are related to mortality decline from three major causes of death: cerebrovascular diseases, ischaemic heart disease, "other heart diseases" according to the Russian abridged classification. For older population, the highest decline is observed for cerebrovascular mortality; mortality from ischaemic heart disease slightly decreased and mortality from "other heart diseases" (determined predominantly by cardiomyopathies of alcohol origin) increased. The efficiency of this program can be substantially increased by introducing specific measures to reduce risks of ischaemic heart disease and behavioural risks related to alcoholism in particular. P2-274