File(s) under permanent embargo

Is birth weight a risk factor for ischemic heart disease in later life?

journal contribution
posted on 01.05.2007, 00:00 authored by Rachel HuxleyRachel Huxley, Christopher G Owen, Peter H Whincup, Derek G Cook, Janet Rich-Edwards, George Davey Smith, Rory Collins
Background:Aninverseassociationbetweenbirthweightandischemic heart disease (IHD) has been seen in observational studies.
Objective: We wanted to determine the strength and consistency of the association between birth weight and subsequent IHD. Design: Weconducted a systematic review of observational studies.
Results: Seventeen published studies of birth weight and subsequentIHD were identified that included a total of 144 794 singletons. Relative risk estimates for the association between birth weight and IHD were available from 16 of these studies. Additional data from 2 unpublished studies of 3801 persons were also included. In total, the analyses included data from 18 studies on 4210 nonfatal and 3308 fatalIHDevents in 147 009 persons. The mean weighted estimate for the association between birth weight and the combined outcome of nonfatal and fatal IHD was 0.84 (95% CI: 0.81, 0.88) per kilogram of birth weight (P < 0.0001). No significant heterogeneity was observed between estimates in different studies (P = 0.09), nor was there evidence of publication bias (P = 0.3, Begg test). Neither restricting the analysis to fatal IHD events nor adjusting for socioeconomic status had any appreciable effect on the findings.
Conclusions: These findings are consistent with a 1 kg higher birth weight being associated with a 10-20% lower risk of subsequent IHD. However, even if causal, interventions to increase birth weight are unlikely to reduce the incidence of IHD materially. Further studies are needed to determine whether the observed association reflects a stronger underlying association with a related exposure or is due (at least in part) to residual confounding.

History

Journal

American Journal of Clinical Nutrition

Volume

85

Issue

5

Pagination

1244 - 1250

Publisher

Oxford University Press

Location

New York, N.Y.

ISSN

0002-9165

Language

eng

Publication classification

C1.1 Refereed article in a scholarly journal

Copyright notice

2007, American Society for Nutrition