Birth weight as destiny?

Abstract

In 1989, Barker et al reported a correlation between lower birth weights and increased risk for death in adulthood from ischemic heart disease in men born between 1911-1930 in England (Lancet 1989;2:577-80. doi: https://doi.org/10.1016/s0140-6736(89)90710-1). Many subsequent studies have affirmed the relationship between birth weight and conditions such as diabetes, hypertension, and obesity. In this volume of The Journal of Pediatrics, Lilja et al report an association between birth weight and stroke in adulthood. The study used a large cohort of Swedish men born in 1945-1961 with recorded birth weight and body measurements until the age of young adult military conscription tests, linked to national disease and cause of death registers. The study found that lower birth weights were associated with an increased risk of stroke, regardless of body mass index in young adulthood. However, men who were overweight in young adulthood were at significantly higher risk. From a public health standpoint, it is important to learn how individuals can mitigate the risks associated with low birth weight and we need more studies such as this one that show how risk is increased or decreased along the lifespan. It is possible that birth weight is destiny, and that the baseline increase in risk incurred by the fetal environment cannot be decreased and disease risks can only be increased by postnatal health. To understand this, we need even deeper studies of how modifiable factors such as early diet and physical exercise interact with perinatal risk factors in both men and women. However, this needs to be studied prospectively with earlier outcomes, so we do not have to wait several more generations to start improving the long-term health of small newborn infants. Article page 162 ▸ Low Birth Weight as an Early-Life Risk Factor for Adult Stroke Among MenThe Journal of PediatricsVol. 237PreviewTo evaluate the association between birth weight and the risk of adult stroke in men, independent of body mass index (BMI) at young adult age. Full-Text PDF Open Access