American Journal of Epidemiology Vol. 152, No. 7 : 605-608
Copyright © 2000 by The Johns Hopkins University School of Hygiene and Public Health
ORIGINAL CONTRIBUTIONS |
Invited Commentary: Association between Restricted Fetal Growth and Adult Chronic Disease: Is It Causal? Is It Important?
1 From the Departments of Pediatrics and of Epidemiology and Biostatistics, McGill University Faculty of Medicine, 1020 Pine Avenue West, Montreal, Quebec, H3A 1 A2, Canada (e-mail: mkrame@po-box.mcgill.ca). (Correspondence to Dr. Kramer at this address).
Abbreviations: CHD, coronary heart disease; SES, socioeconomic status
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INTRODUCTION |
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The article by Leon et al. (1
) adds to the large and expanding body of literature reporting associations between restricted fetal growth and subsequent adult chronic disease, particularly hypertension, type 2 diabetes, and coronary heart disease. In view of the long delay between exposure and outcome in these studies, the reported associations are remarkably robust. Beginning with ecologic studies by Forsdahl (2) in Norway and later by Barker and Osmond (3) in the United Kingdom, subsequent historical and cohort studies from Barker's group based on individual-level analyses have replicated the original findings (4–6). Moreover, the associations have also been confirmed by many different groups of investigators in several countries, including the United Kingdom (7, 8), the United States (9–12), Sweden (13, 14), Finland (15), India (16), Zimbabwe (17), South Africa (18), and Brazil (19).
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IS THE ASSOCIATION CAUSAL? |
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Confounding
Causal paths
Natural experiments
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PUBLIC HEALTH IMPORTANCE |
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CONCLUSION |
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ACKNOWLEDGMENTS |
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REFERENCES |
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