Eero Kajantie1,2,3, Clive Osmond4, Johan G Eriksson1,5,6,7,8. 1. Chronic Disease Prevention Unit, National Institute for Health and Welfare, Helsinki, Finland. 2. Hospital for Children and Adolescents, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland. 3. Department of Obstetrics and Gynaecology, MRC Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland. 4. MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK. 5. Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland. 6. Unit of General Practice, Helsinki University Central Hospital, Helsinki, Finland. 7. Folkhälsan Research Centre, Helsinki, Finland. 8. Vasa Central Hospital, Vasa, Finland.
Abstract
BACKGROUND: Adults born preterm have increased risk factors for cardiovascular disease. We studied the cumulative incidence of manifest coronary heart disease (CHD) and stroke in adults born preterm. METHODS: We studied 19 015 people born in Helsinki, Finland, during 1924-44. Of them, 137 (0.7%) were born early (<34 weeks) and 1006 (5.3%) late preterm (34 to <37 weeks). We ascertained CHD and stroke from the National Hospital Discharge and Death Registers and estimated hazard ratios (HRs) by Cox regression. RESULTS: A total of 3027 subjects (15.9%) had CHD and 1805 (9.5%) stroke. HRs for CHD were 1.17 (95% confidence interval 0.83, 1.65) for early and 0.99 (0.85, 1.14) for late preterm. For stroke, they were 0.84 (0.50, 1.39) and 0.86 (0.71, 1.06). HRs were little changed when adjusted for childhood and adult socio-economic position and birthweight for gestation standard deviation score. They were similar for first-ever events before or after 65 years, for haemorrhagic and thrombotic stroke, and for men and women, except that the HR for CHD for women born early preterm was 1.98 (1.18, 3.30). CONCLUSIONS: We found no increased risk of CHD or stroke up to old age in people born preterm, although women born early preterm had a higher rate of CHD. There is a discrepancy between increased risk factors in younger generations born preterm and little or no increase in manifest disease in older age. Uncovering reasons underlying this discrepancy may give important insights into the prevention of cardiovascular disease.
BACKGROUND: Adults born preterm have increased risk factors for cardiovascular disease. We studied the cumulative incidence of manifest coronary heart disease (CHD) and stroke in adults born preterm. METHODS: We studied 19 015 people born in Helsinki, Finland, during 1924-44. Of them, 137 (0.7%) were born early (<34 weeks) and 1006 (5.3%) late preterm (34 to <37 weeks). We ascertained CHD and stroke from the National Hospital Discharge and Death Registers and estimated hazard ratios (HRs) by Cox regression. RESULTS: A total of 3027 subjects (15.9%) had CHD and 1805 (9.5%) stroke. HRs for CHD were 1.17 (95% confidence interval 0.83, 1.65) for early and 0.99 (0.85, 1.14) for late preterm. For stroke, they were 0.84 (0.50, 1.39) and 0.86 (0.71, 1.06). HRs were little changed when adjusted for childhood and adult socio-economic position and birthweight for gestation standard deviation score. They were similar for first-ever events before or after 65 years, for haemorrhagic and thrombotic stroke, and for men and women, except that the HR for CHD for women born early preterm was 1.98 (1.18, 3.30). CONCLUSIONS: We found no increased risk of CHD or stroke up to old age in people born preterm, although women born early preterm had a higher rate of CHD. There is a discrepancy between increased risk factors in younger generations born preterm and little or no increase in manifest disease in older age. Uncovering reasons underlying this discrepancy may give important insights into the prevention of cardiovascular disease.
Authors: Christine Henriksen; Astrid N Almaas; Ane C Westerberg; Christian A Drevon; Per O Iversen; Britt Nakstad Journal: Eur J Pediatr Date: 2016-08-09 Impact factor: 3.183
Authors: Yulika Yoshida-Montezuma; Erica Stone; Saman Iftikhar; Vanessa De Rubeis; Alessandra T Andreacchi; Charles Keown-Stoneman; Lawrence Mbuagbaw; Hilary K Brown; Russell J de Souza; Laura N Anderson Journal: Paediatr Perinat Epidemiol Date: 2021-11-22 Impact factor: 3.103
Authors: Kari R Risnes; Kristine Pape; Johan H Bjørngaard; Dag Moster; Michael B Bracken; Pal R Romundstad Journal: PLoS One Date: 2016-11-07 Impact factor: 3.240
Authors: Kari Risnes; Josephine Funck Bilsteen; Paul Brown; Anna Pulakka; Anne-Marie Nybo Andersen; Signe Opdahl; Eero Kajantie; Sven Sandin Journal: JAMA Netw Open Date: 2021-01-04
Authors: Mariane Bertagnolli; Thuy Mai Luu; Adam James Lewandowski; Paul Leeson; Anne Monique Nuyt Journal: Curr Hypertens Rep Date: 2016-04 Impact factor: 5.369
Authors: Olov Änghagen; Jan Engvall; Tomas Gottvall; Nina Nelson; Eva Nylander; Peter Bang Journal: Pediatr Cardiol Date: 2022-03-25 Impact factor: 1.838