title: Long-Term Survival of Individuals Born Small and Large for Gestational Age.
abstract: BACKGROUND
  Little is known on long-term survival and causes of death among individuals born small or large for gestational age. This study investigates birth weight in relation to survival and causes of death over time.
  
  
  METHODS
  A national cohort of 1.7 million live-born singletons in Denmark was followed during 1979-2011, using the Danish Civil Registration System, the Medical Birth Registry and the Cause of Death Registry. Cox proportional hazards were estimated for the impact of small (SGA) and large (LGA) gestation weight and mortality overall, by age group and birth cohort.
  
  
  RESULTS
  Compared to normal weight children, SGA children were associated with increased risk of dying over time. Though most of the deaths occurred during the first year of life, the cumulative mortality risk was increased until 30 years of age. The hazard ratios [HR] for dying among SGA children ages <2 years were: 3.47 (95% CI, 3.30-3.64) and 1.06 (95% CI, 0.60-1.87) in 30 years and older. HR for dying among SGA adults (20-29 years) were: 1.20 (95% CI, 0.99-1.46) in years 1979-1982 and 1.61 (95% CI, 1.04-2.51) in years 1989-1994. The SGA born had increased risk of dying from infection, heart disease, respiratory disease, digestive disease, congenital malformation, perinatal conditions, and accidents, suicide, and homicide. Individuals born LGA were associated with decreased mortality risk, but with increased risk of dying from malignant neoplasm.
  
  
  CONCLUSIONS
  Survival has improved independently of birth weight the past 30 years. However, children born SGA remain at significantly increased risk of dying up till they turn 30 years of age. Individuals born LGA have lower mortality risk but only in the first two years of life.
authors.affiliation: Statens Serum Institut, Department of Epidemiology Research, Copenhagen, Denmark.
authors.forename: E Christina M
authors.initials: EC
authors.lastname: Wennerström
authors.affiliation: Statens Serum Institut, Department of Epidemiology Research, Copenhagen, Denmark.
authors.forename: Jacob
authors.initials: J
authors.lastname: Simonsen
authors.affiliation: Statens Serum Institut, Department of Epidemiology Research, Copenhagen, Denmark; Clinical Medicine, Copenhagen University, Copenhagen, Denmark; Department of Medicine, Stanford School of Medicine, Stanford, CA, United States of America.
authors.forename: Mads
authors.initials: M
authors.lastname: Melbye
mesh_terms: D000293:Adolescent; D000328:Adult; D001724:Birth Weight / Q000502:physiology*; D002423:Cause of Death; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003718:Denmark; D005865:Gestational Age; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age / Q000502:physiology*; D007239:Infections / Q000401:mortality; D009369:Neoplasms / Q000401:mortality; D016016:Proportional Hazards Models; D012042:Registries / Q000706:statistics & numerical data*; D018570:Risk Assessment / Q000379:methods / Q000706:statistics & numerical data; D012307:Risk Factors; D017741:Survivors / Q000706:statistics & numerical data*; D055815:Young Adult