Birth weight and mortality in childhood in Norway

In order to estimate the association between intrauterine growth and childhood survival, data on birth weight and gestational age from the Norwegian Birth Registry, for all children who survived the first year of life and who were born during the period 1967-1989 were linked to the National Cause of Death Registry for the period 1968-1991. Deaths were categorized into five cause of death groups: malformations, cancer, infections, accidents, and other causes. The adjusted relative risk of death from all causes at ages 1-5 years was 2.18 (95% confidence interval (CI) 1.85-2.56) for children with birth weight <2,500 g as opposed to children with birth weight > or = 2,500 g. For ages 6-10 years, the corresponding adjusted relative risk (95% CI) was 1.83 (1.35-2.48), and for ages 11-15 years, it was 1.35 (0.91-1.99). Death from infections, accidents, and other causes showed a reversed J-shaped association with birth weight, while malformations showed a log-linear decrease in mortality with increasing birth weight. For cancer deaths, low birth weight showed an opposite association. The association between birth weight and childhood mortality is complex, and cause-specific analyses are necessary to understand the connection between intrauterine influences and later mortality.