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American Journal of Epidemiology Advance Access originally published online on October 31, 2007
American Journal of Epidemiology 2007 166(12):1365-1367; doi:10.1093/aje/kwm314
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American Journal of Epidemiology © The Author 2007. Published by the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org.

Invited Commentary

Invited Commentary: Timing and Types of Cardiovascular Risk Factors in Relation to Offspring Birth Weight

Roberta B. Ness1,2 and Janet Catov2

1 Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA
2 Department of Obstetrics Gynecology and Reproductive Sciences, University of Pittsburgh, Pittsburgh, PA

Correspondence to Dr. Roberta B. Ness, Department of Epidemiology, Graduate School of Public Health, 130 DeSoto Street, A548 Crabtree Hall, Pittsburgh, PA 15261 (e-mail: repro{at}pitt.edu).

Received for publication September 10, 2007. Accepted for publication September 20, 2007.

Birth weight is associated with later-life cardiovascular risk. A new study by Romundstad et al. (Am J Epidemiol 2007;166:1359–1364) challenges us to consider influences on birth weight with respect to timing and type. Timing of effects on birth weight, according to the "fetal origins hypothesis," is in utero. Alternatively, familial aggregation—genetics or shared environment—may explain birth weight and suggests prepregnancy influences. The Romundstad et al. findings support familial effects: maternal metabolic factors predicted birth weight for gestational age. However, because maternal physiology sets the fetal environment, these data do not necessarily counter the fetal origins hypothesis. Types of maternal metabolic influences demonstrated by Romundstad et al. include elevations in blood pressure being associated with lower birth weight for gestational age, whereas unfavorable glucose and lipid levels were associated with higher birth weight. These findings are consistent with the authors prior hypothesis that vascular dysfunction and metabolic profile (glucose and lipids) have divergent effects during pregnancy. Moreover, these new data underscore that both extremes of birth weight may be related to cardiovascular risk. Few data sets contain prepregnancy, pregnancy, and childhood information. Without all such time points, life course effects will remain only partially understood. It is hoped that studies such as the forthcoming National Children's Study will generate critical understanding of this issue.

birth weight; blood pressure; cardiovascular diseases; glucose; lipids; pregnancy complications


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Related articles in Am. J. Epidemiol.:

Associations of Prepregnancy Cardiovascular Risk Factors with the Offspring's Birth Weight
Pål R. Romundstad, George Davey Smith, Tom I. L. Nilsen, and Lars J. Vatten
Am. J. Epidemiol. 2007 166: 1359-1364. [Abstract] [FREE Full Text]  





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