title: Perinatal risk factors for premature ischaemic heart disease in a Swedish national cohort.
abstract: OBJECTIVE
  Several studies have reported associations between restricted fetal development, as shown by birth weight or birth length, and later ischaemic heart disease (IHD). However, few studies have examined the importance of these perinatal factors when taking into account gestational age at birth, hereditary factors, sociodemographic factors and comorbidities. This study investigated the importance of perinatal risk factors for premature IHD and myocardial infarction (MI) in a large Swedish cohort.
  
  
  METHODS
  National cohort study of 1,970,869 individuals who were live-born in Sweden in 1973 through 1992, and followed up to 2010 (ages 18-38 years).
  
  
  METHODS
  The main outcome was IHD, and the secondary outcome was MI.
  
  
  RESULTS
  A total of 668 individuals were diagnosed with IHD in 18.8 million person-years of follow-up. After adjusting for gestational age at birth, sociodemographic factors, comorbidities and family history of IHD, low fetal growth was associated with increased risk of IHD (HR for <-2 vs -1 to <1 SD, 1.54; 95% CI 1.15 to 2.07; p=0.004) and increased risk of MI (HR for <-2 vs -1 to <1 SD, 2.48; 95% CI 1.66 to 3.71; p<0.001) in young adulthood. In contrast, gestational age at birth was not associated with the risk of IHD or MI.
  
  
  CONCLUSIONS
  In this large national cohort, low fetal growth was strongly associated with IHD and MI in young adulthood, independently of gestational age at birth, sociodemographic factors, comorbidities and family history of IHD.
authors.affiliation: Center for Primary Health Care Research, Lund University, Malmö, Sweden.
authors.forename: Bengt
authors.initials: B
authors.lastname: Zöller
authors.affiliation: Center for Primary Health Care Research, Lund University, Malmö, Sweden Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, California, USA.
authors.forename: Jan
authors.initials: J
authors.lastname: Sundquist
authors.affiliation: Center for Primary Health Care Research, Lund University, Malmö, Sweden Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, California, USA.
authors.forename: Kristina
authors.initials: K
authors.lastname: Sundquist
authors.affiliation: Department of Medicine, Stanford University School of Medicine, Stanford, California, USA.
authors.forename: Casey
authors.initials: C
authors.lastname: Crump
mesh_terms: D000293:Adolescent; D000328:Adult; D001724:Birth Weight; D001827:Body Height; D015331:Cohort Studies; D005260:Female; D047109:Fetal Development; D005500:Follow-Up Studies; D005865:Gestational Age; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000453:epidemiology; D017202:Myocardial Ischemia / Q000453:epidemiology*; D012307:Risk Factors; D012959:Socioeconomic Factors; D013548:Sweden / Q000453:epidemiology; D055815:Young Adult
keywords: EPIDEMIOLOGY; PAEDIATRICS