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

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)

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.

This record has no associated files available for download.

Contributors

Download statistics