Finnish Institute for Health and Welfare, Finland.
Faculty of Medicine, University of Helsinki, Finland.
Scand J Public Health. 2022 Jul;50(5):613-621. doi: 10.1177/14034948211019792. Epub 2021 May 31.
Socio-economic conditions in early life are important contributors to cardiovascular disease - the leading cause of mortality globally - in later life. We studied coronary heart disease (CHD) and stroke in adulthood among people born out of wedlock in two historical periods: before and during World War II in Finland. We compared offspring born out of wedlock before (1934-1939) and during (1940-1944) World War II with the offspring of married mothers in the Helsinki Birth Cohort Study. The war affected the position of unmarried mothers in society. We followed the study subjects from 1971 to 2014 and identified deaths and hospital admissions from CHD and stroke. Data were analysed using a Cox regression, adjusting for other childhood and adulthood socio-economic circumstances. The rate of out-of-wedlock births was 240/4052 (5.9%) before World War II and 397/9197 (4.3%) during World War II. Among those born before World War II, out-of-wedlock birth was associated with an increased risk of stroke (hazard ratio (HR)=1.44; 95% confidence interval (CI) 1.00-2.07) and CHD (HR=1.37; 95% CI 1.02-1.86). Among those born out of wedlock during World War II, the risks of stroke (HR=0.89; 95% CI 0.58-1.36) and CHD (HR=0.70; 95% CI 0.48=1.03) were similar to those observed for the offspring of married mothers. The -values for interaction of unmarried×World War II were (=0.015) for stroke and (=0.003) for CHD.
人生早期的社会经济状况是导致心血管疾病（全球主要死亡原因）的重要因素。我们研究了两个历史时期芬兰非婚生人群成年期的冠心病（CHD）和中风：二战前（1934-1939 年）和二战期间（1940-1944 年）。我们将非婚生子女与已婚母亲的后代进行了比较，后者来自于赫尔辛基出生队列研究。战争影响了未婚母亲在社会中的地位。我们从 1971 年开始对研究对象进行随访，直到 2014 年，记录了冠心病和中风导致的死亡和住院情况。采用 Cox 回归分析数据，同时调整了其他儿童和成年时期的社会经济情况。二战前，非婚生子女的出生率为 240/4052（5.9%），而二战期间则为 397/9197（4.3%）。在二战前出生的人群中，非婚生子女发生中风的风险增加（风险比（HR）=1.44；95%置信区间（CI）1.00-2.07）和 CHD（HR=1.37；95% CI 1.02-1.86）。在二战期间非婚生子女中，中风（HR=0.89；95% CI 0.58-1.36）和 CHD（HR=0.70；95% CI 0.48=1.03）的风险与已婚母亲的后代相似。非婚生×二战的交互检验值为（=0.015）用于中风，（=0.003）用于 CHD。
