title: Fetal growth and later maternal death, cardiovascular disease and diabetes.
abstract: OBJECTIVE
  Low birthweight of the offspring has been associated with increased risk of early death and ischemic heart disease in the mother. However, other measurements of fetal growth than the basic birthweight are more accurate. We investigated the relation between the standardized birthweight by gestational age and gender and the ponderal index and the mother's subsequent mortality and cardiovascular morbidity.
  
  
  METHODS
  Registry-based retrospective cohort study.
  
  
  METHODS
  Women with a first singleton delivery in Denmark from 1978 to 2007.
  
  
  METHODS
  782 287 women followed for 14.6 years yielding 11 600 945 person-years.
  
  
  METHODS
  Cox proportional hazard models.
  
  
  METHODS
  The primary exposures were variation in the standardized birthweight and ponderal index. The endpoints were subsequent maternal death, hypertension, ischemic heart disease, stroke, thrombosis, and diabetes mellitus.
  
  
  RESULTS
  The risk-profile for the standardized birthweight and subsequent maternal death had a nadir between -0.5 and -1 SD (HR 0.91; 95%CI 0.83-1.00) and increased with decreasing fetal growth peaking at <-3 SD (HR 2.75; 95%CI 2.37-3.19) compared to the median. The risk-profile for subsequent diabetes mellitus by standardized ponderal index had a nadir between +0.5 to +1 SD (HR 0.82; 95%CI 0.76-0.89) rising with increasing fetal growth and peaking at >+3 SD (HR 17.8; 95%CI 15.0-21.0). The risk-profiles for standardized ponderal index paralleled those for birthweight, but with smaller risk estimates. Adjusting for other pregnancy complications diminished the estimates.
  
  
  CONCLUSIONS
  The fetal growth is a marker of subsequent risk for premature death, cardiovascular disease, and diabetes mellitus in the mother.
authors.affiliation: Dept. of Obstetrics and Gynecology, Roskilde Hospital, Denmark.
authors.forename: Jacob A
authors.initials: JA
authors.lastname: Lykke
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Paidas
authors.forename: Elizabeth W
authors.initials: EW
authors.lastname: Triche
authors.forename: Jens
authors.initials: J
authors.lastname: Langhoff-Roos
mesh_terms: D000293:Adolescent; D000328:Adult; D001724:Birth Weight; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology*; D015331:Cohort Studies; D003718:Denmark / Q000453:epidemiology; D003920:Diabetes Mellitus / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D047109:Fetal Development; D005500:Follow-Up Studies; D006305:Health Status Indicators; D006801:Humans; D007231:Infant, Newborn; D008875:Middle Aged; D061213:Mortality, Premature; D011247:Pregnancy; D016016:Proportional Hazards Models; D012015:Reference Standards; D012042:Registries; D012189:Retrospective Studies; D012306:Risk; D055815:Young Adult