Department of Obstetrics and Gynaecology, University of Cambridge, The Rosie Hospital, Cambridge CB2 0SW, UK.
Am J Epidemiol. 2010 Mar 15;171(6):736-44. doi: 10.1093/aje/kwp448. Epub 2010 Feb 4.
Pregnancy complications and cardiovascular disease share some common determinants. It has previously been hypothesized that family history of cardiovascular disease would be associated with low birth weight. Records from 120,317 Scottish births, 1992-2006, were linked to hospital admission and death certificate data for 71,681 pairs of maternal grandparents. There was a negative relation between the birth weight of the baby and the risk of either grandparent's experiencing ischemic heart disease (for a 1-kg increase in birth weight, hazard ratio = 0.86, 95% confidence interval: 0.83, 0.89) or cerebrovascular disease (hazard ratio = 0.82, 95% confidence interval: 0.77, 0.87). Further analysis demonstrated that the associations were explained by increased risks of both delivering a small-for-gestational-age infant and delivering preterm among women whose parents had experienced cardiovascular disease. Adjustment for the mother's characteristics at the time of the birth attenuated the relation, but significant associations persisted: With a 1-kg increase in birth weight, the adjusted hazard ratio for ischemic heart disease = 0.93 (95% confidence interval: 0.89, 0.96) and for cerebrovascular disease = 0.93 (95% confidence interval: 0.89, 0.96). Familial aggregation of common determinants of pregnancy complications and cardiovascular disease is the likely explanation for the relation between an infant's birth weight and the risk of cardiovascular disease in other family members.
妊娠并发症和心血管疾病有一些共同的决定因素。先前有研究假设，心血管疾病家族史与低出生体重有关。1992 年至 2006 年期间，苏格兰 120317 例出生记录与 71681 对母婴外婆家的住院和死亡证明数据相关联。婴儿出生体重与外祖母或外祖父发生缺血性心脏病（出生体重每增加 1 公斤，风险比=0.86，95%置信区间：0.83，0.89）或脑血管疾病（风险比=0.82，95%置信区间：0.77，0.87）的风险呈负相关。进一步分析表明，这些关联可归因于母亲的父母患有心血管疾病的女性中，小胎龄儿和早产的风险增加。调整出生时母亲的特征后，这种关联有所减弱，但仍存在显著关联：出生体重每增加 1 公斤，缺血性心脏病的调整后风险比=0.93（95%置信区间：0.89，0.96），脑血管疾病的调整后风险比=0.93（95%置信区间：0.89，0.96）。妊娠并发症和心血管疾病常见决定因素的家族聚集可能是婴儿出生体重与其他家庭成员心血管疾病风险之间关系的原因。
