The relation of small head circumference and thinness at birth to death from cardiovascular disease in adult life.
OBJECTIVE
To determine how fetal growth is related to death from cardiovascular disease in adult life.


METHODS
A follow up study of men born during 1907-24 whose birth weights, head circumferences, and other body measurements were recorded at birth.


METHODS
Sheffield, England.


METHODS
1586 Men born in the Jessop Hospital.


METHODS
Death from cardiovascular disease.


RESULTS
Standardised mortality ratios for cardiovascular disease fell from 119 in men who weighed 5.5 pounds (2495 g) or less at birth to 74 in men who weighed more than 8.5 pounds (3856 g). The fall was significant for premature cardiovascular deaths up to 65 years of age (chi 2 = 5.0, p = 0.02). Standardised mortality ratios also fell with increasing head circumference (chi 2 = 4.6, p = 0.03) and increasing ponderal index (weight/length3) (chi 2 = 3.8, p = 0.05; for premature deaths chi 2 = 6.0, p = 0.01). They were not related to the duration of gestation. Among men for whom the ratio of placental weight to birth weight was in the highest fifths the standardised mortality ratio was 137.


CONCLUSIONS
These findings show that reduced fetal growth is followed by increased mortality from cardiovascular disease. They suggest that reduction in growth begins early in gestation. They are further evidence that cardiovascular disease originates through programming of the body's structure, physiology, and metabolism by the environment during fetal life. Maternal nutrition may have an important influence on programming.
Barker
D J
DJ
MRC Environmental Epidemiology Unit, Southampton General Hospital.
Osmond
C
C
Simmonds
S J
SJ
Wield
G A
GA
D000328:Adult; D000375:Aging / Q000502:physiology; D001724:Birth Weight; D001827:Body Height; D002318:Cardiovascular Diseases / Q000401:mortality*; D002508:Cephalometry; D005314:Embryonic and Fetal Development; D004739:England / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D005865:Gestational Age; D006257:Head / Q000033:anatomy & histology*; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects; D012307:Risk Factors; D012923:Social Class