Abstract
Increased population longevity could be influenced by early life factors. Some areas have long-lived populations, also in a historical perspective. We aimed to study these factors in Halland, an area with the highest life expectancy in Sweden. We collected archival data on gestational age and birth characteristics from 995 live singleton full-term births at the Halmstad Hospital, Halland, from the period 1936 to 1938 and compared these to 3364 births from three hospitals in nearby Scania for the period 1935-1945. In addition, data were obtained on maternal and offspring characteristics from the national Swedish Medical Birth Register during 1973-2013. The results show that when controlling for background maternal and offspring characteristics, mean birth weight (BW) and mean birth length were higher in Halland than in Scania, but the proportion of low birth weight (LBW) and small for gestational age (SGA) was lower. However, mean BW for Halland did not differ from the rest of Sweden in recent years 2004-2013. We also conducted a mortality follow-up for children born in Scania, which showed that LBW, being born SGA, or short birth length reduced survival. In conclusion, the high mean life expectancy in Halland compared to the rest of Sweden could have been associated with beneficial early life factors influencing birth size in the past. In more recent decades the mean BW of Halland is not different from the national mean. Thus, longevity could be expected to become more equal to the national mean in the future.
Highlights
Life programing has been intensively studied for prediction of adult morbidity and mortality, as well as life expectancy in various populations.[1,2] One important measure of this is birth weight (BW) adjusted for gestational age, which reflects fetal growth patterns.[1]
Average birth length was higher in Halmstad Birth Study (HBS) (51.5 cm) than in Scanian Birth Study (SBS) (50.9 cm)
Average Ponderal index (PI) was lower in HSB (25.7 kg/m3) than in SBS (26.7 kg/m3), which reflects the fact that children born in Halmstad were longer but weighed nearly the same as those born in Landskrona and surroundings
Summary
Life programing has been intensively studied for prediction of adult morbidity and mortality, as well as life expectancy in various populations.[1,2] One important measure of this is birth weight (BW) adjusted for gestational age, which reflects fetal growth patterns.[1]. The cardiovascular mortality rate in Halland is significantly lower than the rest of Sweden and cannot be explained only by higher socioeconomic status (SES) as a marker of better material conditions.[7] In 2019, death rates in Halland from diseases of the circulatory system were 201.2 and 284.3 per 100,000 for women and men, respectively, compared to the national averages of 230.1 and 328.1 deaths per 100,000, making Halland the county with the lowest rates for men, and second lowest rates for women after Stockholm.[8] The population in Halland is amongst the tallest in Sweden. Average height in the South Sweden region, comprising the counties of Scania and Blekinge, was 172.8 cm, while the national average was 172.5 cm
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