N-H Morken1,2,3, F Halland1,3, L A DeRoo1,4, A J Wilcox4, R Skjaerven1,5,6. 1. Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway. 2. Department of Clinical Science, University of Bergen, Bergen, Norway. 3. Department of Obstetrics & Gynaecology, Haukeland University Hospital, Bergen, Norway. 4. Epidemiology Branch, NIEHS/NIH, Durham, NC, USA. 5. Medical Birth Registry of Norway, Bergen, Norway. 6. Norwegian Institute of Public Health, Bergen, Norway.
Abstract
OBJECTIVE: To estimate risk of parental cardiovascular disease mortality by offspring birthweight. DESIGN: Population-based cohort study. SETTING AND POPULATION: Norwegian mothers and fathers with singleton births during 1967-2002 were followed until 2009 by linkage to the Norwegian cause of death registry. METHODS: Hazard ratios by offspring absolute birthweight in grams and birthweight adjusted for gestational age (z-score) were calculated using Cox regression and adjusted for parental age at delivery and year of first birth. Stratified analyses on preterm and term births were performed. MAIN OUTCOME MEASURES: Maternal and paternal cardiovascular mortality. RESULTS: We followed 711 726 mothers and 700 212 fathers and found a strong link between maternal cardiovascular mortality and offspring birthweight but only slight evidence of associations in fathers. Adjusting birthweight for gestational age (by z-score) uncovered an unexpected strong association of large birthweight (z-score > 2.5) with mothers' cardiovascular mortality (hazard ratio 3.0, 95% CI 2.0-4.6). This risk was apparently restricted to preterm births. In stratified analyses (preterm and term births) hazard ratios for maternal cardiovascular mortality were 1.5 (1.03-2.2) for large preterm babies and 0.9 (0.7-1.2) for large term babies (P-value for interaction = 0.02), using normal weight preterm and term, respectively, as references. CONCLUSION: Women having large preterm babies are at increased risk of both diabetes and cardiovascular mortality. The birth of a large preterm baby should increase clinical vigilance for onset of diabetes and other cardiovascular disease risk factors. TWEETABLE ABSTRACT: Birth of a large preterm baby should increase vigilance for cardiovascular-disease risk factors.
OBJECTIVE: To estimate risk of parental cardiovascular disease mortality by offspring birthweight. DESIGN: Population-based cohort study. SETTING AND POPULATION: Norwegian mothers and fathers with singleton births during 1967-2002 were followed until 2009 by linkage to the Norwegian cause of death registry. METHODS: Hazard ratios by offspring absolute birthweight in grams and birthweight adjusted for gestational age (z-score) were calculated using Cox regression and adjusted for parental age at delivery and year of first birth. Stratified analyses on preterm and term births were performed. MAIN OUTCOME MEASURES: Maternal and paternal cardiovascular mortality. RESULTS: We followed 711 726 mothers and 700 212 fathers and found a strong link between maternal cardiovascular mortality and offspring birthweight but only slight evidence of associations in fathers. Adjusting birthweight for gestational age (by z-score) uncovered an unexpected strong association of large birthweight (z-score > 2.5) with mothers' cardiovascular mortality (hazard ratio 3.0, 95% CI 2.0-4.6). This risk was apparently restricted to preterm births. In stratified analyses (preterm and term births) hazard ratios for maternal cardiovascular mortality were 1.5 (1.03-2.2) for large preterm babies and 0.9 (0.7-1.2) for large term babies (P-value for interaction = 0.02), using normal weight preterm and term, respectively, as references. CONCLUSION:Women having large preterm babies are at increased risk of both diabetes and cardiovascular mortality. The birth of a large preterm baby should increase clinical vigilance for onset of diabetes and other cardiovascular disease risk factors. TWEETABLE ABSTRACT: Birth of a large preterm baby should increase vigilance for cardiovascular-disease risk factors.
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