Eriksson, Johan G., Kajantie, Eero, Thornburg, Kent L., Osmond, Clive and Barker, David J. P.
Mother's body size and placental size predict coronary heart disease in men
European Heart Journal, 32, (18), . (doi:10.1093/eurheartj/ehr147). (PMID:21632601).
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Aims People whose birthweights were towards the lower end of the normal range are at increased risk of coronary heart
disease. This is attributed to foetal programming through malnutrition, but the cause of the malnutrition is unknown.
We studied 6975 men born in Helsinki during 1934–44. Their size at birth was recorded. Babies who later developed
coronary heart disease tended to have a low ponderal index (birthweight/length3). Three different placental phenotypes
predicted the disease. In primiparous mothers who were short, having below median height, the hazard ratio
for the disease was 1.14 (95% confidence interval 1.08–1.21, P , 0.0001) for each centimetre increase in the difference
between the length and breadth of the placental surface. In tall mothers whose body mass index was above the
median, the hazard ratio was 1.25 (1.10–1.42, P ¼ 0.0007) per 40 cm2 decrease in the surface area. In tall mothers
whose body mass index was below the median, the hazard ratio was 1.07 (1.02–1.13, P ¼ 0.01) per 1% increase in
the placental weight/birthweight ratio.
Conclusions Three different combinations of maternal and placental size predicted coronary heart disease. The mother’s body size
determines the availability of nutrients and is linked to the development and function of the placenta, reflected in its
shape and size. We speculate that variations in three processes of normal placental development lead to foetal
malnutrition. The processes are (i) implantation and spiral artery invasion, (ii) growth of the chorionic surface,
and (iii) compensatory expansion of the chorionic surface.
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