The impact of birth weight on cardiovascular disease risk in the Women's Health Initiative
C J Smith1, K K Ryckman1, V M Barnabei2
1University of Iowa Department of Epidemiology, College of Public Health, 145 N. Riverside Drive, Iowa City, IA, 52242, USA.
Insights
Low birth weight is linked to increased cardiovascular disease risk in post-menopausal women. This finding highlights the importance of early life factors in predicting adult heart health outcomes.
Area of Science:
- Cardiovascular disease research
- Developmental origins of health and disease
Background:
- Cardiovascular disease (CVD) is a leading global cause of death.
- Traditional risk factors explain most CVD risk, but early life experiences are increasingly recognized.
- The Barker hypothesis suggests fetal origins of adult disease, with birth weight as a key indicator.
Purpose of the Study:
- To investigate the association between birth weight and cardiovascular disease risk.
- To determine if birth weight improves CVD risk prediction models.
Main Methods:
- Analysis of the Women's Health Initiative (WHI) cohort (63,815 post-menopausal women).
- Evaluation of self-reported birth weight categories against CVD outcomes using proportional hazards regression.
- Assessment of birth weight's predictive value in BMI-based and laboratory-based CVD risk equations.
Main Results:
- Low birth weight (LBW) (<6 lbs.) was significantly associated with all CVD outcome definitions in univariable analyses (HR = 1.086, p = 0.009).
- LBW was a significant predictor in the BMI-based CVD risk model (HR = 1.128, p < 0.0001).
- LBW did not significantly predict CVD events in the lipid-based models.
Conclusions:
- Low birth weight (<6 lbs.) is independently associated with cardiovascular disease outcomes in post-menopausal women.
- These findings support the role of the prenatal and postnatal environment in adult chronic disease development.
Background And Aims:
Cardiovascular disease (CVD) is among the leading causes of morbidity and mortality worldwide. Traditional risk factors predict 75-80% of an individual's risk of incident CVD. However, the role of early life experiences in future disease risk is gaining attention. The Barker hypothesis proposes fetal origins of adult disease, with consistent evidence demonstrating the deleterious consequences of birth weight outside the normal range. In this study, we investigate the role of birth weight in CVD risk prediction.
Methods And Results:
The Women's Health Initiative (WHI) represents a large national cohort of post-menopausal women with 63,815 participants included in this analysis. Univariable proportional hazards regression analyses evaluated the association of 4 self-reported birth weight categories against 3 CVD outcome definitions, which included indicators of coronary heart disease, ischemic stroke, coronary revascularization, carotid artery disease and peripheral arterial disease. The role of birth weight was also evaluated for prediction of CVD events in the presence of traditional risk factors using 3 existing CVD risk prediction equations: one body mass index (BMI)-based and two laboratory-based models. Low birth weight (LBW) (<6 lbs.) was significantly associated with all CVD outcome definitions in univariable analyses (HR = 1.086, p = 0.009). LBW was a significant covariate in the BMI-based model (HR = 1.128, p < 0.0001) but not in the lipid-based models.
Conclusion:
LBW (<6 lbs.) is independently associated with CVD outcomes in the WHI cohort. This finding supports the role of the prenatal and postnatal environment in contributing to the development of adult chronic disease.
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