Birth Weight, Childhood Body Mass Index and Risk of Coronary Heart Disease in Adults: Combined Historical Cohort Studies

Background Low birth weight and high childhood body mass index (BMI) is each associated with an increased risk of coronary heart disease (CHD) in adult life. We studied individual and combined associations of birth weight and childhood BMI with the risk of CHD in adulthood. Methods/Principal Findings Birth weight and BMI at age seven years were available in 216,771 Danish and Finnish individuals born 1924–1976. Linkage to national registers for hospitalization and causes of death identified 8,805 CHD events during up to 33 years of follow-up (median = 24 years) after age 25 years. Analyses were conducted with Cox regression based on restricted cubic splines. Using median birth weight of 3.4 kg as reference, a non-linear relation between birth weight and CHD was found. It was not significantly different between cohorts, or between men and women, nor was the association altered by childhood BMI. For birth weights below 3.4 kg, the risk of CHD increased linearly and reached 1.28 (95% confidence limits: 1.13 to 1.44) at 2 kg. Above 3.4 kg the association weakened, and from about 4 kg there was virtually no association. BMI at age seven years was strongly positively associated with the risk of CHD and the relation was not altered by birth weight. The excess risk in individuals with a birth weight of 2.5 kg and a BMI of 17.7 kg/m2 at age seven years was 44% (95% CI: 30% to 59%) compared with individuals with median values of birth weight (3.4 kg) and BMI (15.3 kg/m2). Conclusions/Significance Birth weight and BMI at age seven years appeared independently associated with the risk of CHD in adulthood. From a public health perspective we suggest that particular attention should be paid to children with a birth weight below the average in combination with excess relative weight in childhood.

[1]  C Osmond,et al.  Catch-up growth in childhood and death from coronary heart disease: longitudinal study , 1999, BMJ.

[2]  D. Barker.  Fetal programming of coronary heart disease , 2002, Trends in Endocrinology & Metabolism.

[3]  R. Gray.  Modeling Survival Data: Extending the Cox Model , 2002 .

[4]  P. Grambsch,et al.  Modeling Survival Data: Extending the Cox Model , 2000 .

[5]  David A. Schoenfeld,et al.  Partial residuals for the proportional hazards regression model , 1982 .

[6]  D.,et al.  Regression Models and Life-Tables , 2022 .

[7]  T. Sørensen,et al.  Cohort profile: the Copenhagen School Health Records Register. , 2009, International journal of epidemiology.

[8]  P. McKeigue,et al.  Reduced fetal growth rate and increased risk of death from ischaemic heart disease: cohort study of 15 000 Swedish men and women born 1915-29 , 1998, BMJ.

[9]  K. Overvad,et al.  Birth Weight in Relation to Leisure Time Physical Activity in Adolescence and Adulthood: Meta-Analysis of Results from 13 Nordic Cohorts , 2009, PloS one.

[10]  V. Gudnason,et al.  Size at birth and coronary artery disease in a population with high birth weight. , 2002, The American journal of clinical nutrition.

[11]  C Osmond,et al.  Growth in utero and during childhood among women who develop coronary heart disease: longitudinal study , 1999, BMJ.

[12]  C. Byrne,et al.  Fetal origins of adult disease: epidemiology and mechanisms , 2000, Journal of clinical pathology.

[13]  C Osmond,et al.  Mother's weight in pregnancy and coronary heart disease in a cohort of finnish men: follow up study , 1997, BMJ.

[14]  S. Cnattingius,et al.  Perinatal Risk Factors for Ischemic Heart Disease: Disentangling the Roles of Birth Weight and Preterm Birth , 2008, Circulation.

[15]  S. Greenland.  Dose‐Response and Trend Analysis in Epidemiology: Alternatives to Categorical Analysis , 1995, Epidemiology.

[16]  J. Eriksson,et al.  The infant growth of boys who later develop coronary heart disease , 2004, Annals of medicine.

[17]  A. Andersen,et al.  The influence of birth weight and body mass in early adulthood on early coronary heart disease risk among Danish men born in 1953 , 2008, European Journal of Epidemiology.

[18]  T. Sørensen,et al.  [Childhood body mass index and the risk of coronary heart disease in adulthood]. , 2007, Ugeskrift for laeger.

[19]  D. Cook,et al.  P2-43 Birth weight and risk of type 2 diabetes: a quantitative systematic review of published evidence , 2007 .

[20]  T. Sørensen,et al.  Stability of the association between birth weight and childhood overweight during the development of the obesity epidemic. , 2005, Obesity research.

[21]  R. Collins,et al.  Is birth weight a risk factor for ischemic heart disease in later life? , 2007, The American journal of clinical nutrition.

[22]  F. Lemire,et al.  Physical activity to prevent cardiovascular disease. How much is enough? , 2002, Canadian family physician Medecin de famille canadien.

[23]  D. Barker,et al.  WEIGHT IN INFANCY AND DEATH FROM ISCHAEMIC HEART DISEASE , 1989, The Lancet.

[24]  M. Pearce,et al.  Parental recall of birth weight: how accurate is it? , 2000, Archives of disease in childhood.

[25]  C Osmond,et al.  Early growth and death from cardiovascular disease in women. , 1993, BMJ.

[26]  J. Eriksson,et al.  Infant Growth and Stroke in Adult Life: The Helsinki Birth Cohort Study , 2007, Stroke.

[27]  P. Andersen,et al.  Birth weight and systolic blood pressure in adolescence and adulthood: meta-regression analysis of sex- and age-specific results from 20 Nordic studies. , 2007, American journal of epidemiology.

[28]  C. Levy-marchal,et al.  Consequences of being born small for gestational age on body composition: an 8-year follow-up study. , 2008, The Journal of clinical endocrinology and metabolism.

[29]  J. Eriksson,et al.  Early growth and coronary heart disease in later life: longitudinal study , 2001, BMJ : British Medical Journal.

[30]  M. Osler,et al.  The validity of the diagnosis of acute myocardial infarction in routine statistics: a comparison of mortality and hospital discharge data with the Danish MONICA registry. , 2003, Journal of clinical epidemiology.

[31]  N. Solomons.  Developmental origins of health and disease: concepts, caveats, and consequences for public health nutrition. , 2009, Nutrition reviews.

[32]  E. Weiderpass,et al.  Anthropometric characteristics as predictors of coronary heart disease in women , 2008, Journal of internal medicine.

[33]  T. Hansen,et al.  Overweight and the metabolic syndrome in adult offspring of women with diet-treated gestational diabetes mellitus or type 1 diabetes. , 2009, The Journal of clinical endocrinology and metabolism.

[34]  Debbie A Lawlor,et al.  Birth weight and risk of type 2 diabetes: a systematic review. , 2008, JAMA.

[35]  D. Lawlor,et al.  Association of body mass index measured in childhood, adolescence, and young adulthood with risk of ischemic heart disease and stroke: findings from 3 historical cohort studies. , 2006, The American journal of clinical nutrition.

[36]  T. F. Andersen,et al.  The Danish National Hospital Register. A valuable source of data for modern health sciences. , 1999, Danish medical bulletin.

[37]  J. Virtamo,et al.  Validity of diagnoses of major coronary events in national registers of hospital diagnoses and deaths in Finland , 1997, European Journal of Epidemiology.

[38]  D. Barker,et al.  Adult Consequences of Fetal Growth Restriction , 2006, Clinical obstetrics and gynecology.

[39]  Sunil J Rao,et al.  Regression Modeling Strategies: With Applications to Linear Models, Logistic Regression, and Survival Analysis , 2003 .

[40]  L. Murray,et al.  Parental recall of birthweight: A good proxy for recorded birthweight? , 2004, European Journal of Epidemiology.

[41]  P. Elliott,et al.  Size at birth, weight gain over the life course, and low-grade inflammation in young adulthood: northern Finland 1966 Birth Cohort study. , 2008, European heart journal.

[42]  J. Eriksson,et al.  Fetal origins of adult disease: strength of effects and biological basis. , 2002, International journal of epidemiology.

[43]  F. Rasmussen,et al.  Body mass index in late adolescence and its association with coronary heart disease and stroke in middle age among Swedish men , 2007, International Journal of Obesity.

[44]  J. Eriksson,et al.  Growth before 2 years of age and serum lipids 60 years later: the Helsinki Birth Cohort study. , 2008, International journal of epidemiology.

[45]  J. Eriksson,et al.  Extreme hypertrophic cardiomyopathy , 2003, Heart.

[46]  J. Eriksson,et al.  Trajectories of growth among children who have coronary events as adults. , 2005, The New England journal of medicine.

[47]  R. Baggott.  DISEASE , 1947, Social Policy & Administration.

[48]  K. Juel,et al.  The Danish registers of causes of death. , 1999, Danish medical bulletin.

[49]  V. Salomaa,et al.  The validity of hospital discharge register data on coronary heart disease in Finland , 1997, European Journal of Epidemiology.

[50]  J. Eriksson,et al.  Size at Birth, Fat-Free Mass and Resting Metabolic Rate in Adult Life , 2002, Hormone and metabolic research = Hormon- und Stoffwechselforschung = Hormones et metabolisme.

[51]  J. Eriksson,et al.  Childhood growth and coronary heart disease in later life , 2002, Annals of medicine.

[52]  V. Gudnason,et al.  Association between size at birth, truncal fat and obesity in adult life and its contribution to blood pressure and coronary heart disease; study in a high birth weight population , 2004, European Journal of Clinical Nutrition.

[53]  Debbie A Lawlor,et al.  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 , 2005, Circulation.

[54]  T. Sørensen,et al.  Weight at Birth and All-Cause Mortality in Adulthood , 2008, Epidemiology.