American Journal of Epidemiology Advance Access originally published online on April 23, 2007
American Journal of Epidemiology 2007 166(6):634-645; doi:10.1093/aje/kwm042
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Birth Weight and Systolic Blood Pressure in Adolescence and Adulthood: Meta-Regression Analysis of Sex- and Age-specific Results from 20 Nordic Studies
1 Institute of Preventive Medicine, Copenhagen University Hospital, Copenhagen, Denmark
2 Department of Public Health and Caring Science/Geriatrics, Faculty of Medicine, Uppsala University, Uppsala, Sweden
3 Department of Public Health Sciences, Karolinska Institute, Stockholm, Sweden
4 Department of Biostatistics, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
5 Department of Primary Health Care, Sahlgrenska Academy, Göteborg University, Göteborg, Sweden
6 Department of Epidemiology and Public Health, Faculty of Medicine, Imperial College London, London, United Kingdom
7 Departments of Public Health and General Practice, Faculty of Medicine, University of Oulu, Oulu, Finland
8 Northwest Institute for Bio-Health Informatics, Faculty of Medical and Human Sciences, University of Manchester, Manchester, United Kingdom
9 Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
10 Department of Epidemiology, SINTEF Health Research, SINTEF (Foundation for Scientific and Industrial Research), Trondheim, Norway
11 Diabetes and Genetic Epidemiology Unit, Department of Epidemiology and Health Promotion, National Public Health Institute, Helsinki, Finland
12 Unit for Nutrition Research, Landspitali-University Hospital and University of Iceland, Reykjavik, Iceland
13 Centre for Health Equity Studies, Stockholm University/Karolinska Institute, Stockholm, Sweden
14 Maternal Nutrition Group, Danish Epidemiology Science Centre, Statens Serum Institut, Copenhagen, Denmark
15 Department of Human Nutrition and Centre for Advanced Food Studies, Royal Veterinary and Agricultural University, Frederiksberg, Denmark
16 Research Institute of Public Health, University of Kuopio, Kuopio, Finland
17 Environmental Epidemiology Unit, National Public Health Institute, Kuopio, Finland
Correspondence to Dr. Thorkild I. A. Sørensen, Institute of Preventive Medicine, Copenhagen University Hospital, Center for Health and Society, Øster Søgade 18, 1357 Copenhagen K, Denmark (e-mail: tias{at}ipm.regionh.dk).
Received for publication September 19, 2005. Accepted for publication March 21, 2007.
The authors investigated the shape, sex- and age-dependency, and possible confounding of the association between birth weight and systolic blood pressure (SBP) in 197,954 adults from 20 Nordic cohorts (birth years 1910–1987), one of which included 166,249 Swedish male conscripts. Random-effects meta-regression analyses were performed on estimates obtained from age- and sex-stratified analyses within each of the cohorts. There was an inverse association between birth weight and SBP, irrespective of adjustment for concurrent body mass index. The association was linear for males, but for females with a birth weight greater than 4 kg, SBP increased with birth weight (p < 0.01). The association was stronger in the older age groups (p < 0.05), although this could have been a birth cohort effect. The association was stronger among females than among males (p = 0.005) when birth weight was less than or equal to 4 kg. The estimated effect of birth weight on SBP at age 50 years was –1.52 mmHg/kg (95% confidence interval: –2.27, –0.77) in men and –2.80 mmHg/kg (95% confidence interval: –3.85, –1.76) in women. Exclusion of the Swedish conscripts produced nearly identical results. This meta-analysis supports the evidence of an inverse birth weight-SBP association, regardless of adjustment for concurrent body size. It also reveals important heterogeneity in the shape and strength of the association by sex and age.
birth weight; blood pressure; cardiovascular diseases; fetal development; growth; meta-analysis; publication bias; regression analysis
Abbreviations: CI, confidence interval; SBP, systolic blood pressure; SSRC, stratum-specific regression coefficient
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