The association between the risk of adult cerebral vascular disease and the intrauterine growth: A retrospective birth cohort study in a Chinese population
Objective: To investigate the possible relationship between the risk of cerebral vascular disease (CVD) in adulthood and the intrauterine growth in a Chinese cohort. Methods: Two thousand five hundred and three infants born in the Peking Union Medical College Hospital in Beijing during 1921 to 1941 and 1948 to 1954 were followed-up and their medical records at birth were reviewed. Among them, 2085 grown-ups agreed to participate in this study at the Department of Neurology of Peking Union Medical College Hospital from September 2003 to March 2005.Patient questionnaire, case history, clinical assessment and computer tomography brain scan were examined in each of patients to make a diagnosis of CVD. Statistic analysis of χ 2 test, t-test and Logistic regression analysis were conducted to investigate a relationship between the risk of adult CVD and intrauterine growth. Results: One hundred and twenty-eight (6.1%) participants were diagnosed with CVD, including 68 of infarction, 9 of hemorrhage and 53 of asymptomatic infarction. Risk for CVD was significantly related to low birth weight. The association remained significant after adjusting for other growth indexes at birth and adulthood confounding factors using multiple factors Logistic regression analysis. Compared to the control group (birth weight 3001-3500 g), the rate of CVD increased by 86% to 8.7% in lower birth weight (2500-3000 g) and showed to be a risk factor for CVD (OR = 1.86, 95% CI 1.14-3.00), while higher birth weight (> 3500 g) with 2.4% rate of CVD was a risk factor (OR = 0.32, 95% CI 0.13-0.77). Multiple factors Logistic regression analysis suggested that age, hypertension and overweight were also significantly related to adult CVD (P < 0.05). Conclusions: The study for the first time indicates strong evidence of an association between birth weight and adult cerebral vascular disease in a Chinese population. Lower birth weight (2500-3000 g) relates to a high risk of CVD, and higher birth weight (> 3500 g) relates to a protective role in CVD. Age, hypertension and obesity are also risk factors of CVD. © 2009 by the Chinese Medical Association.
Hu, HT; Zhang, ZX; Wen, HB; Wang, ZS; Xiao, XH; Xu, T; Liu, AM; Gai, MY; Zeng, Y
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