The relationship between umbilical cord length and chronic rheumatic heart disease: a prospective cohort study
The relationship between umbilical cord length and chronic rheumatic heart disease: a prospective cohort study
Background: One previous, preliminary study reported that the length of the umbilical cord at birth is related to the risk of developing chronic rheumatic heart disease in later life. We sought to replicate this finding.
Design: Prospective, population-based birth cohort.
Methods: We traced 11,580 individuals born between 1915 and 1929 in Uppsala, Sweden. We identified cases with a main or secondary diagnosis of chronic rheumatic heart disease in the Swedish national inpatient, outpatient or death registers. Archived obstetric records provided data on umbilical cord length, gestational age, birthweight and placental weight.
Results: There were 136 patients with chronic rheumatic heart disease (72 men and 64 women) with a mean age at first hospital admission of 68 years (range 36-92). There was evidence of a positive association between umbilical cord length and risk of subsequent chronic rheumatic heart disease. The overall hazard ratio in the Swedish study (1.13, 95% confidence interval 1.01 to 1.27) was similar to that of the previous study, with some suggestion of larger effect in men than in women. No other birth characteristics were predictive except for weak evidence of a protective effect of higher birthweight in men.
Conclusions: People with longer umbilical cords at birth are more likely to develop chronic rheumatic heart disease in later life. As longer umbilical cords have more spiral arteries and a higher vascular resistance, we hypothesize that the increased pressure load on the heart leads to changes in endothelial biology and increased vulnerability to the autoimmune process initiated by infection with β-haemolytic streptococci.
Adult, Age Factors, Aged, Aged, 80 and over, Chronic Disease, Female, Humans, Infant, Newborn, Male, Middle Aged, Patient Admission, Prospective Studies, Registries, Rheumatic Heart Disease/diagnosis, Risk Assessment, Risk Factors, Sweden/epidemiology, Time Factors, Umbilical Cord/anatomy & histology
1154-1160
Goodman, Anna
9a327c3d-163f-4659-b24b-8b04ef6f7625
Kajantie, Eero
c1db7428-b2c0-46f9-92c3-bcd8cdd452fd
Osmond, Clive
2677bf85-494f-4a78-adf8-580e1b8acb81
Eriksson, Johan
bed81786-e72a-4710-a5b7-ddc6732bc45a
Koupil, Ilona
a45299c0-54e9-4410-8317-7a0934217e10
Thornburg, Kent
b407f955-ba0d-458b-8e16-5c536ab12605
Phillips, David I W
29b73be7-2ff9-4fff-ae42-d59842df4cc6
1 September 2015
Goodman, Anna
9a327c3d-163f-4659-b24b-8b04ef6f7625
Kajantie, Eero
c1db7428-b2c0-46f9-92c3-bcd8cdd452fd
Osmond, Clive
2677bf85-494f-4a78-adf8-580e1b8acb81
Eriksson, Johan
bed81786-e72a-4710-a5b7-ddc6732bc45a
Koupil, Ilona
a45299c0-54e9-4410-8317-7a0934217e10
Thornburg, Kent
b407f955-ba0d-458b-8e16-5c536ab12605
Phillips, David I W
29b73be7-2ff9-4fff-ae42-d59842df4cc6
Goodman, Anna, Kajantie, Eero, Osmond, Clive, Eriksson, Johan, Koupil, Ilona, Thornburg, Kent and Phillips, David I W
(2015)
The relationship between umbilical cord length and chronic rheumatic heart disease: a prospective cohort study.
European Journal of Preventive Cardiology, 22 (9), .
(doi:10.1177/2047487314544082).
Abstract
Background: One previous, preliminary study reported that the length of the umbilical cord at birth is related to the risk of developing chronic rheumatic heart disease in later life. We sought to replicate this finding.
Design: Prospective, population-based birth cohort.
Methods: We traced 11,580 individuals born between 1915 and 1929 in Uppsala, Sweden. We identified cases with a main or secondary diagnosis of chronic rheumatic heart disease in the Swedish national inpatient, outpatient or death registers. Archived obstetric records provided data on umbilical cord length, gestational age, birthweight and placental weight.
Results: There were 136 patients with chronic rheumatic heart disease (72 men and 64 women) with a mean age at first hospital admission of 68 years (range 36-92). There was evidence of a positive association between umbilical cord length and risk of subsequent chronic rheumatic heart disease. The overall hazard ratio in the Swedish study (1.13, 95% confidence interval 1.01 to 1.27) was similar to that of the previous study, with some suggestion of larger effect in men than in women. No other birth characteristics were predictive except for weak evidence of a protective effect of higher birthweight in men.
Conclusions: People with longer umbilical cords at birth are more likely to develop chronic rheumatic heart disease in later life. As longer umbilical cords have more spiral arteries and a higher vascular resistance, we hypothesize that the increased pressure load on the heart leads to changes in endothelial biology and increased vulnerability to the autoimmune process initiated by infection with β-haemolytic streptococci.
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More information
Accepted/In Press date: 30 June 2014
Published date: 1 September 2015
Keywords:
Adult, Age Factors, Aged, Aged, 80 and over, Chronic Disease, Female, Humans, Infant, Newborn, Male, Middle Aged, Patient Admission, Prospective Studies, Registries, Rheumatic Heart Disease/diagnosis, Risk Assessment, Risk Factors, Sweden/epidemiology, Time Factors, Umbilical Cord/anatomy & histology
Identifiers
Local EPrints ID: 479307
URI: http://eprints.soton.ac.uk/id/eprint/479307
ISSN: 2047-4873
PURE UUID: 03b437ae-827d-4727-83e9-83f74c3fb4cf
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Date deposited: 20 Jul 2023 16:54
Last modified: 17 Mar 2024 02:42
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Contributors
Author:
Anna Goodman
Author:
Eero Kajantie
Author:
Johan Eriksson
Author:
Ilona Koupil
Author:
Kent Thornburg
Author:
David I W Phillips
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