The intrauterine environment and adult cardiovascular disease.

Two recent findings suggest that maternal nutrition, and fetal and infant growth, have an important effect on the risk of cardiovascular disease in adult life. (1) Among 5225 men who were born in Hertfordshire, England during 1911-1930 and who were breast fed, those who had the lowest weights at birth and at one year had the highest death rates from cardiovascular disease. The differences were large and were reflected in differences in life expectancy. (2) In England and Wales there is a close geographical association between high death rates from cardiovascular disease, and poor maternal physique and health, and poor fetal growth. These findings raise the question of what processes link the intrauterine and early postnatal environment with risk of cardiovascular disease. Blood pressure, a known risk factor for cardiovascular disease, is one link. A recent study of 449 men and women now aged 50 showed that measurements at birth predicted blood pressure more strongly than current measures such as body mass. Levels of clotting factors in the blood and serum cholesterol (two other risk factors) may also be links.