Birthweight and mortality in adulthood: a systematic review and meta-analysis

TY - JOUR

T1 - Birthweight and mortality in adulthood: a systematic review and meta-analysis

AU - Risnes, Kari R

AU - Vatten, Lars J

AU - Baker, Jennifer L

AU - Jameson, Karen

AU - Sovio, Ulla

AU - Kajantie, Eero

AU - Osler, Merete

AU - Morley, Ruth

AU - Jokela, Markus

AU - Painter, Rebecca C

AU - Sundh, Valter

AU - Jacobsen, Geir W

AU - Eriksson, Johan G

AU - Sørensen, Thorkild I A

AU - Bracken, Michael B

AU - Jacobsen, Geir W

PY - 2011/6

Y1 - 2011/6

N2 - Background: Small birth size may be associated with increased risk of cardiovascular diseases (CVD), whereas large birth size may predict increased risk of obesity and some cancers. The net effect of birth size on long-term mortality has only been assessed in individual studies, with conflicting results. Methods: The Meta-analyses of Observational Studies in Epidemiology (MOOSE) guidelines for conducting and reporting meta-analysis of observational studies were followed. We retrieved 22 studies that assessed the association between birthweight and adult mortality from all causes, CVD or cancer. The studies were systematically reviewed and those reporting hazard ratios (HRs) and 95% confidence intervals (95% CIs) per kilogram (kg) increase in birthweight were included in generic inverse variance meta-analyses. Results: For all-cause mortality, 36 834 deaths were included and the results showed a 6% lower risk (adjusted HR=0.94, 95% CI: 0.92-0.97) per kg higher birthweight for men and women combined. For cardiovascular mortality, the corresponding inverse association was stronger (HR=0.88, 95% CI: 0.85-0.91). For cancer mortality, HR per kg higher birthweight was 1.13 (95% CI: 1.07-1.19) for men and 1.04 (95% CI: 0.98-1.10) for women (P interaction=0.03). Residual confounding could not be eliminated, but is unlikely to account for the main findings. Conclusion: These results show an inverse but moderate association of birthweight with adult mortality from all-causes and a stronger inverse association with cardiovascular mortality. For men, higher birthweight was strongly associated with increased risk of cancer deaths. The findings suggest that birthweight can be a useful indicator of processes that influence long-term health. Published by Oxford University Press on behalf of the International Epidemiological Association.

AB - Background: Small birth size may be associated with increased risk of cardiovascular diseases (CVD), whereas large birth size may predict increased risk of obesity and some cancers. The net effect of birth size on long-term mortality has only been assessed in individual studies, with conflicting results. Methods: The Meta-analyses of Observational Studies in Epidemiology (MOOSE) guidelines for conducting and reporting meta-analysis of observational studies were followed. We retrieved 22 studies that assessed the association between birthweight and adult mortality from all causes, CVD or cancer. The studies were systematically reviewed and those reporting hazard ratios (HRs) and 95% confidence intervals (95% CIs) per kilogram (kg) increase in birthweight were included in generic inverse variance meta-analyses. Results: For all-cause mortality, 36 834 deaths were included and the results showed a 6% lower risk (adjusted HR=0.94, 95% CI: 0.92-0.97) per kg higher birthweight for men and women combined. For cardiovascular mortality, the corresponding inverse association was stronger (HR=0.88, 95% CI: 0.85-0.91). For cancer mortality, HR per kg higher birthweight was 1.13 (95% CI: 1.07-1.19) for men and 1.04 (95% CI: 0.98-1.10) for women (P interaction=0.03). Residual confounding could not be eliminated, but is unlikely to account for the main findings. Conclusion: These results show an inverse but moderate association of birthweight with adult mortality from all-causes and a stronger inverse association with cardiovascular mortality. For men, higher birthweight was strongly associated with increased risk of cancer deaths. The findings suggest that birthweight can be a useful indicator of processes that influence long-term health. Published by Oxford University Press on behalf of the International Epidemiological Association.

U2 - 10.1093/ije/dyq267

DO - 10.1093/ije/dyq267

M3 - Journal article

SN - 0300-5771

VL - 40

SP - 647

EP - 661

JO - International Journal of Epidemiology

JF - International Journal of Epidemiology

IS - 3

ER -