Birth Weight, Childhood Body Mass Index and Risk of Coronary Heart Disease in Adults: Combined Historical Cohort Studies

Abstract

BackgroundLow birth weight and high childhood body mass index (BMI) is each associated with an increased risk of coronary heart disease (CHD) in adult life. We studied individual and combined associations of birth weight and childhood BMI with the risk of CHD in adulthood.Methods/Principal FindingsBirth weight and BMI at age seven years were available in 216,771 Danish and Finnish individuals born 1924–1976. Linkage to national registers for hospitalization and causes of death identified 8,805 CHD events during up to 33 years of follow-up (median = 24 years) after age 25 years. Analyses were conducted with Cox regression based on restricted cubic splines. Using median birth weight of 3.4 kg as reference, a non-linear relation between birth weight and CHD was found. It was not significantly different between cohorts, or between men and women, nor was the association altered by childhood BMI. For birth weights below 3.4 kg, the risk of CHD increased linearly and reached 1.28 (95% confidence limits: 1.13 to 1.44) at 2 kg. Above 3.4 kg the association weakened, and from about 4 kg there was virtually no association. BMI at age seven years was strongly positively associated with the risk of CHD and the relation was not altered by birth weight. The excess risk in individuals with a birth weight of 2.5 kg and a BMI of 17.7 kg/m2 at age seven years was 44% (95% CI: 30% to 59%) compared with individuals with median values of birth weight (3.4 kg) and BMI (15.3 kg/m2).Conclusions/SignificanceBirth weight and BMI at age seven years appeared independently associated with the risk of CHD in adulthood. From a public health perspective we suggest that particular attention should be paid to children with a birth weight below the average in combination with excess relative weight in childhood.

Heart rate variability analysis of normal and growth restricted children

“…Andersen et al (2010), found that birth weight and BMI at the age of seven appears to exercise mutually independent effects on the risk of cardiovascular disease [1]. They described that children with a combination of low birth weight and relatively high BMI had a cardiac risk of 44%.…”

“…Andersen and co-workers described that higher BMI in children with very low birth weight is associated with higher cardiac risk [1].…”

Fetal and Infant Growth Patterns and Kidney Function at School Age

“…24 It has been postulated that rapid weight gain and obesity in childhood are associated with an increased risk of hypertension and type 2 diabetes in adulthood, which are risk factors for kidney disease. 11,12 In a retrospective cohort study among 80 children with proteinuric kidney disease, obese children who were born preterm had an increased risk of progression of kidney disease compared with obese children who were born at term, suggesting an additive risk of obesity and prematurity in the risks for progression of kidney disease. 25 Experimental studies have shown that adequate feeding of low birth weight rats could restore nephron numbers to normal and that overfeeding of these rats led to low nephron numbers, hypertension, and renal injury.…”

“…1 Longitudinal studies suggested that the associations of low birth weight with hypertension were stronger in subjects with rapid weight gain in childhood, but results are inconclusive. 11,12 A similar growth pattern has not been identified as a risk factor for kidney diseases yet.…”

Comparison of Different Internationally Accepted Reference Standards to Measure Childhood Adiposity Rates in Latvia

“…Elevated BMI in childhood is strongly associated with increased risk of coronary heart disease in adulthood, as well as increased risk of acute coronary syndrome (Baker et al, 2007;Jensen et al, 2008;Andersen et al, 2010 (Krûmiòa u.c., 2007). With this variety of reference standards available, it is important for physicians to use scales that are appropriate for the evaluation of individual children, because the future management of their assigned therapy depends on precise and accurate evaluation of excess weight.…”