Ischemic heart disease: gestational age at birth portends adult risk

  • Crump C & al.
  • JAMA Pediatr
  • 3 Jun 2019

  • International Clinical Digest
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Takeaway

  • Preterm (
  • Authors: findings call for long-term follow-up, prevention in this population.

Why this matters

  • Editorial: despite known increased risk for hypertension, diabetes in this population, US and European guidelines do not cite preterm/early-term birth as an indication for screening.

Key results

  • 0.09% of cohort was diagnosed with IHD during 30.9 million person-years of follow-up.
  • For adults ages 18-43 years, vs being born full-term, adjusted HRs (95% CIs):
    • Birth at
    • Birth at 37-38 weeks: 1.16 (1.02-1.31).
  • For adults ages 30-43 years, vs being born full-term, aHRs (95% CIs):
    • Birth at
    • Birth at 37-38 weeks: 1.19 (1.01-1.40).
  • Women born preterm had a higher aHR vs men: 1.93 (1.28-2.90) vs 1.37 (1.01-1.84).
  • Gestational age at birth was inversely associated with IHD risk: aHR per additional week of gestation, 0.96 (95% CI, 0.93-0.98).

Study design

  • National population-based Swedish cohort study of 2,141,709 singleton births, 1973-1994.
  • Outcomes: IHD diagnosis.
  • Funding: NIH; Swedish Research Council; others. 

Limitations

  • No data on spontaneous vs medically indicated preterm birth.

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