International Journal of Epidemiology 2003;32:193-198
© International Epidemiological Association 2003
Special Theme: Cancer |
Birthweight differences between USA and China and their relevance to breast cancer aetiology
1 Department of Hygiene and Epidemiology, School of Medicine, University of Athens, Greece.
2 Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA.
3 University of Massachusetts Cancer Center, Worcester, MA, USA.
4 Department of Epidemiology, School of Public Health, Shanghai Medical University, Shanghai, China.
5 Department of Medical Epidemiology, Karolinska Institutet, Stockholm, Sweden.
Correspondence: Dimitrios Trichopoulos, Department of Epidemiology, Harvard School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA. E-mail: dtrichop{at}hsph.harvard.edu
Background There has been renewed interest about determinants of birth size following the propagation of hypotheses that birth size parameters may have long-term consequences on the occurrence of common diseases in adulthood, including breast cancer.
Methods In the context of a cohort study, 296 Caucasian pregnant women in Boston, USA and 329 Chinese pregnant women in Shanghai, China were followed to term. Birth size characteristics of the baby and maternal anthropometry were measured using standardized protocols. Analyses were conducted through multiple regression procedures.
Results No significant difference was found between US and Chinese newborns with respect to gestational age. Among US women, pregravid oral contraceptive use was strongly associated with higher birthweight. In both US and Chinese women, birthweight was positively associated with height, pre-pregnancy body mass index, and weight gain during pregnancy. More importantly, the difference in these three maternal variables between the two samples fully explains the birthweight difference between the two populations.
Conclusions We postulate that babies in China may have lower birthweight because their mothers’ anthropometry imposes constraints on the growth of the fetus. When Chinese women migrate to the US, they tend to grow taller and heavier so that their babies can reach, on the average, a higher birthweight. The recurrence of this process in successive generations could explain why eventually Chinese Americans tend to have comparable birth and adult anthropometric characteristics, as well as comparable breast cancer rates, to those of Caucasian Americans.
Keywords Birthweight, China, US, breast cancer
Accepted 13 June 2002
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