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Birthweight and mortality in adulthood: a systematic review and meta-analysis

Birthweight and mortality in adulthood: a systematic review and meta-analysis
Birthweight and mortality in adulthood: a systematic review and meta-analysis
Background: small birth size may be associated with increased risk of cardiovascular
diseases (CVD), whereas large birth size may predict increased
risk of obesity and some cancers. The net effect of birth size on
long-term mortality has only been assessed in individual studies,
with conflicting results.

Methods: the Meta-analyses of Observational Studies in Epidemiology
(MOOSE) guidelines for conducting and reporting meta-analysis
of observational studies were followed. We retrieved 22 studies
that assessed the association between birthweight and adult mortality
from all causes, CVD or cancer. The studies were systematically
reviewed and those reporting hazard ratios (HRs) and 95%
confidence intervals (95% CIs) per kilogram (kg) increase in birthweight
were included in generic inverse variance meta-analyses.

Results: for all-cause mortality, 36 834 deaths were included and the results
showed a 6% lower risk (adjusted HR¼0.94, 95% CI: 0.92–0.97) per
kg higher birthweight for men and women combined. For cardiovascular
mortality, the corresponding inverse association was stronger
(HR¼0.88, 95% CI: 0.85–0.91). For cancer mortality, HR per kg
higher birthweight was 1.13 (95% CI: 1.07–1.19) for men and 1.04
(95% CI: 0.98–1.10) for women (Pinteraction¼0.03). Residual confounding
could not be eliminated, but is unlikely to account for
the main findings.

Conclusion: these results show an inverse but moderate association of birthweight
with adult mortality from all-causes and a stronger inverse
association with cardiovascular mortality. For men, higher
birthweight was strongly associated with increased risk of cancer
deaths. The findings suggest that birthweight can be a useful indicator
of processes that influence long-term health.
birthweight, gestational age, all-cause mortality, cardiovascular mortality, cancer mortality, early origins of health and disease hypothesis
0300-5771
647-661
Risnes, Kari R.
a074dd31-c04f-4b3e-8c74-1f897cbc8bdb
Vatten, Lars J.
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Baker, Jennifer L.
2b17824c-8908-4421-b8dd-4f97a8c58d0c
Jameson, Karen
d5fb142d-06af-456e-9016-17497f94e9f2
Sovio, Ulla
e7cd7dd6-dd07-498f-bba4-08cc12962698
Kajantie, Eero
d68d55b6-6df1-4195-a914-44c738a6db93
Osler, Merete
d9a38d79-f985-4b6b-94d9-f79714125351
Morley, Ruth
71e7c170-025f-40cc-936f-744784ae0d1f
Jokela, Markus
52034bce-51a0-4ba4-b6f8-56918d909a8c
Painter, Rebecca C.
9c48514b-b4e8-438a-940c-bbfc7e11a1ac
Sundh, Valter
d105360b-10c6-4e6f-ba72-08c585343d18
Jacobsen, Geir W.
7042104c-40af-48cb-aa77-5672bf03b72d
Eriksson, Johan G.
eb96b1c5-af07-4a52-8a73-7541451d32cd
Sørensen, Thorkild I. A.
c2e37ca6-5a48-4728-b64c-fc998cc60906
Bracken, Michael B.
eac18876-c5f8-4b69-9c53-a7cd0b651a0c
Risnes, Kari R.
a074dd31-c04f-4b3e-8c74-1f897cbc8bdb
Vatten, Lars J.
7f7e7925-6b2a-4089-a7da-c865a633fa5e
Baker, Jennifer L.
2b17824c-8908-4421-b8dd-4f97a8c58d0c
Jameson, Karen
d5fb142d-06af-456e-9016-17497f94e9f2
Sovio, Ulla
e7cd7dd6-dd07-498f-bba4-08cc12962698
Kajantie, Eero
d68d55b6-6df1-4195-a914-44c738a6db93
Osler, Merete
d9a38d79-f985-4b6b-94d9-f79714125351
Morley, Ruth
71e7c170-025f-40cc-936f-744784ae0d1f
Jokela, Markus
52034bce-51a0-4ba4-b6f8-56918d909a8c
Painter, Rebecca C.
9c48514b-b4e8-438a-940c-bbfc7e11a1ac
Sundh, Valter
d105360b-10c6-4e6f-ba72-08c585343d18
Jacobsen, Geir W.
7042104c-40af-48cb-aa77-5672bf03b72d
Eriksson, Johan G.
eb96b1c5-af07-4a52-8a73-7541451d32cd
Sørensen, Thorkild I. A.
c2e37ca6-5a48-4728-b64c-fc998cc60906
Bracken, Michael B.
eac18876-c5f8-4b69-9c53-a7cd0b651a0c

Risnes, Kari R., Vatten, Lars J., Baker, Jennifer L., Jameson, Karen, Sovio, Ulla, Kajantie, Eero, Osler, Merete, Morley, Ruth, Jokela, Markus, Painter, Rebecca C., Sundh, Valter, Jacobsen, Geir W., Eriksson, Johan G., Sørensen, Thorkild I. A. and Bracken, Michael B. (2011) Birthweight and mortality in adulthood: a systematic review and meta-analysis. International Journal of Epidemiology, 40 (3), 647-661. (doi:10.1093/ije/dyq267). (PMID:21324938)

Record type: Article

Abstract

Background: small birth size may be associated with increased risk of cardiovascular
diseases (CVD), whereas large birth size may predict increased
risk of obesity and some cancers. The net effect of birth size on
long-term mortality has only been assessed in individual studies,
with conflicting results.

Methods: the Meta-analyses of Observational Studies in Epidemiology
(MOOSE) guidelines for conducting and reporting meta-analysis
of observational studies were followed. We retrieved 22 studies
that assessed the association between birthweight and adult mortality
from all causes, CVD or cancer. The studies were systematically
reviewed and those reporting hazard ratios (HRs) and 95%
confidence intervals (95% CIs) per kilogram (kg) increase in birthweight
were included in generic inverse variance meta-analyses.

Results: for all-cause mortality, 36 834 deaths were included and the results
showed a 6% lower risk (adjusted HR¼0.94, 95% CI: 0.92–0.97) per
kg higher birthweight for men and women combined. For cardiovascular
mortality, the corresponding inverse association was stronger
(HR¼0.88, 95% CI: 0.85–0.91). For cancer mortality, HR per kg
higher birthweight was 1.13 (95% CI: 1.07–1.19) for men and 1.04
(95% CI: 0.98–1.10) for women (Pinteraction¼0.03). Residual confounding
could not be eliminated, but is unlikely to account for
the main findings.

Conclusion: these results show an inverse but moderate association of birthweight
with adult mortality from all-causes and a stronger inverse
association with cardiovascular mortality. For men, higher
birthweight was strongly associated with increased risk of cancer
deaths. The findings suggest that birthweight can be a useful indicator
of processes that influence long-term health.

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More information

Published date: June 2011
Keywords: birthweight, gestational age, all-cause mortality, cardiovascular mortality, cancer mortality, early origins of health and disease hypothesis
Organisations: Faculty of Health Sciences

Identifiers

Local EPrints ID: 210960
URI: http://eprints.soton.ac.uk/id/eprint/210960
ISSN: 0300-5771
PURE UUID: 519b31b9-4057-4fc7-95b2-5ce257f05b5f

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Date deposited: 16 Feb 2012 09:56
Last modified: 14 Mar 2024 04:51

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Contributors

Author: Kari R. Risnes
Author: Lars J. Vatten
Author: Jennifer L. Baker
Author: Karen Jameson
Author: Ulla Sovio
Author: Eero Kajantie
Author: Merete Osler
Author: Ruth Morley
Author: Markus Jokela
Author: Rebecca C. Painter
Author: Valter Sundh
Author: Geir W. Jacobsen
Author: Johan G. Eriksson
Author: Thorkild I. A. Sørensen
Author: Michael B. Bracken

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