International Journal of Epidemiology 2001;30:853-862
© International Epidemiological Association 2001
Cardiovascular Disease |
Fetal exposure, heredity and risk indicators for cardiovascular disease in a Swedish welfare cohort
a Department of Clinical Science, Obstetrics and Gynecology,
b Department of Public Health and Clinical Medicine, Epidemiology,
c Department of Public Health and Clinical Medicine, Medicine and
d Department of Public Health and Clinical Medicine, Behavioural Medicine, Umeå University, S-90185 Umeå, Sweden.
Abstract
Background The overall aim was to test whether low birthweight (LBW) in newborns is associated with the risk indicators for cardiovascular disease in early middle age, even in a welfare society. Further, a possible interaction of LBW and heredity for myocardial infarction or stroke was investigated.
Methods Overall, subjects were identified as newborns in a local birth register, and as adult participants, in the Västerbotten Intervention Program (n = 7876). Outcome measures such as systolic (SBP) and diastolic blood pressures (DBP), body mass index (BMI), cholesterol, triglycerides and anthropometrics were investigated (at age 29–41 years) in relation to LBW.
Results Low birthweight was associated with increased SBP and DBP. Triglycerides were elevated among women with LBW and total cholesterol was elevated in men with LBW. Heredity for myocardial infarction or stroke interacted with LBW, and indicated a synergistic effect on the level of SBP. The BMI did not differ between LBW and normal birthweight subjects.
Conclusions Our interpretation is that the ‘fetal origins’ hypothesis' is valid for middle-age subjects who grow up in a welfare society. The population attributable proportions that result from different exposures to LBW were relatively small overall; from a public health perspective, heredity was more important than LBW for elevated SBP.
Keywords Low birthweight, prenatal-exposure delayed effects, hypertension, cholesterol, triglycerides
Accepted 21 December 2000
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