Kaijser Magnus, Bonamy Anna-Karin Edstedt, Akre Olof, Cnattingius Sven, Granath Fredrik, Norman Mikael, Ekbom Anders
Clinical Epidemiology Unit, Department of Medicine, Karolinska Institutet, Stockholm, Sweden.
Circulation. 2008 Jan 22;117(3):405-10. doi: 10.1161/CIRCULATIONAHA.107.710715. Epub 2008 Jan 2.
Several studies have reported an association between low birth weight and ischemic heart disease, but it remains unclear whether the association is mediated through poor fetal growth or short gestational duration.
In a cohort study, we have identified all subjects born preterm or with a low birth weight at 4 major delivery units in Sweden from 1925 through 1949. For comparison, an equal number of subjects with none of these criteria were identified within the same source population. The study population consists of 6425 subjects, of whom 2931 were born before 37 weeks of gestation and 2176 had a birth weight < 2500 g. Fetal growth was estimated through birth weight for gestational age. The cohort was followed up for occurrence of ischemic heart disease through the nationwide Hospital Discharge and Cause of Death Registries during the period of 1987 through 2002. In the cohort, 617 cases of ischemic heart disease occurred. Compared with subjects with a normal fetal growth, those born small for gestational age (birth weight < or = -2 SD below the mean) were at increased risk of ischemic heart disease (adjusted hazard ratio, 1.64; 95% confidence interval, 1.23 to 2.18). The negative association between fetal growth and risk of ischemic heart disease was independent of gestational duration.
The association between low birth weight and adult risk of ischemic heart disease appears to be mediated entirely by poor fetal growth.
多项研究报告了低出生体重与缺血性心脏病之间的关联，但该关联是否通过胎儿生长发育不良或孕期短介导尚不清楚。
在一项队列研究中，我们确定了1925年至1949年在瑞典4个主要分娩单位早产或出生体重低的所有受试者。作为对照，在同一来源人群中确定了同等数量无上述标准的受试者。研究人群包括6425名受试者，其中2931名在妊娠37周前出生，2176名出生体重<2500g。通过出生体重与孕周的关系来估计胎儿生长情况。在1987年至2002年期间，通过全国医院出院和死亡原因登记处对该队列进行随访，观察缺血性心脏病的发生情况。该队列中发生了617例缺血性心脏病。与胎儿生长正常的受试者相比，小于胎龄儿（出生体重低于均值2个标准差或更低）患缺血性心脏病的风险增加（校正风险比为1.64；95%可信区间为1.23至2.18）。胎儿生长与缺血性心脏病风险之间的负相关独立于孕周。
低出生体重与成人缺血性心脏病风险之间的关联似乎完全由胎儿生长发育不良介导。
