title: Prenatal and maternal characteristics and later risk for coronary heart disease among women.
abstract: OBJECTIVE
  The pace and pathways of early growth have major influences on later health. Coronary heart disease (CHD) is a major killer and kills more women than men, but usually manifests about 10 years later in women. Therefore there are fewer studies of early growth and CHD amongst women than men.
  
  
  METHODS
  The Helsinki Birth Cohort Study includes 9817 women born during 1924-1944. We used national registers to identify hospital admissions and deaths from CHD during 1971-2010. We used a Cox model to obtain hazard ratios (HRs) for CHD.
  
  
  RESULTS
  Altogether 967 women (9.9%) developed CHD. Socioeconomic factors were strongly and inversely associated with CHD. Neither maternal age nor body mass index (BMI) was associated with CHD in the daughters. There were inverse associations of birth weight (p = 0.07) and length (p = 0.02) with CHD in adult life. We divided the mothers according to parity. Daughters of primiparous women had lower birth weight and shorter birth length than the offspring of multiparous women (both p-values < 0.001). Birth weight (p = 0.008), birth length (p = 0.05) and birth BMI (p = 0.02) were all inversely associated with CHD. Among first-born women, a 1 kg increase in birth weight was associated with a 25% lower risk for CHD (HR 0.75, 95% confidence interval (CI) 0.60-0.93). The findings changed little after adjustment for socioeconomic factors. Among later-born women none of the birth characteristics was associated with CHD.
  
  
  CONCLUSIONS
  Small birth size is associated with CHD among women. First-born women with high birth weight appear to be at lower risk for CHD compared with later born women.
authors.affiliation: National Institute for Health and Welfare, Department of Chronic Disease Prevention, Finland Department of General Practice and Primary Health Care, University of Helsinki, Finland Vasa Central Hospital, Finland Folkhälsan Research Centre, Helsingfors Universitet, Finland Unit of General Practice, Helsinki University Central Hospital, Finland johan.eriksson@helsinki.fi.
authors.forename: Johan G
authors.initials: JG
authors.lastname: Eriksson
authors.affiliation: National Institute for Health and Welfare, Department of Chronic Disease Prevention, Finland Hospital for Children and Adolescents, Helsinki University Central Hospital, Finland Department of Obstetrics and Gynaecology, Oulu University Hospital, Finland.
authors.forename: Eero
authors.initials: E
authors.lastname: Kajantie
authors.affiliation: Heart Research Center, Oregon Health and Science University, USA.
authors.forename: Kent
authors.initials: K
authors.lastname: Thornburg
authors.affiliation: MRC Lifecourse Epidemiology Unit, Southampton General Hospital, UK.
authors.forename: Clive
authors.initials: C
authors.lastname: Osmond
mesh_terms: D000328:Adult; D001724:Birth Weight; D015331:Cohort Studies; D003324:Coronary Artery Disease / Q000453:epidemiology*; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D010298:Parity; D011247:Pregnancy; D012307:Risk Factors; D012923:Social Class
keywords: Coronary heart disease; parity; prenatal growth; women