Relationship between birth size and coronary heart disease in China.

BACKGROUND: Clinical epidemiological studies suggested a link between fetal growth conditions and later coronary heart disease (CHD) in adult life. However, no such studies have been conducted in a Chinese population. OBJECTIVES: We investigated the association between various birth characteristics and CHD occurrence in a Chinese cohort. DESIGN: Retrospective cohort study. SETTING: Peking Union Medical College Hospital, Beijing, China. PARTICIPANTS: A total of 2,033 subjects who were born at Peking Union Medical College Hospital between 1921 and 1954. MEASUREMENTS: Neonatal birth-weight, placental weight, length from crown to heel, head circumference, and biparietal and occipitofrontal diameters were routinely recorded at the time of birth. All participants were followed up between May 2002 and April 2004 for the occurrence of CHD. RESULTS: CHD was identified in 135 patients. The occurrence of CHD was inversely related to birth sizes, such as birth-weight, head circumference, placental weight (P < 0.05), but was not significantly related to birth length or ponderal index (birth-weight/birth length(3)). After multivariable logistic regression, the ratio of birth-weight to birth length was an independent predictor of CHD along with two other variables: obesity and age. LIMITATIONS: This was a single-center retrospective study. CONCLUSIONS: In China low birth size or birth disproportion, which is suggestive of fetal growth retardation, has an effect on CHD occurrence during adulthood. This suggests that environmental factors operate in both the prenatal and postnatal periods with regard to the development of CHD.