Delivery of a Small for Gestational Age Infant and Greater Maternal Risk of Ischemic Heart Disease

• Type of Material: Article
• Authors: Radek Bukowski, University of Texas, Galveston; Karen Davis, Emory University; Peter Wilson, Emory University
• Language: English
• Date: 2012-03-14
• Publisher: Public Library of Science
• Publication Version: Final Published Version
• Copyright Statement: © 2012 Bukowski et al.
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1371/journal.pone.0033047
• Title of Journal or Parent Work: PLoS ONE
• ISSN: 1932-6203
• Volume: 7
• Issue: 3
• Start Page: e33047
• End Page: e33047
• Grant/Funding Information: These authors have no support or funding to report.
• Keywords: FOLLOW-UP; PREGNANCY; Science & Technology; PREECLAMPSIA; MORTALITY; PARENTAL CARDIOVASCULAR-DISEASE; Multidisciplinary Sciences; PRETERM BIRTH; MULTIDISCIPLINARY SCIENCES; ATHEROSCLEROSIS; Science & Technology - Other Topics; BIRTH-WEIGHT; HISTORY; WOMEN
• Research Categories: Health Sciences, Medicine and Surgery; Health Sciences, Obstetrics and Gynecology

Abstract

Background: Delivery of a small for gestational age (SGA) infant has been associated with increased maternal risk of ischemic heart disease (IHD). It is uncertain whether giving birth to SGA infant is a specific determinant of later IHD, independent of other risk factors, or a marker of general poor health. The purpose of this study was to investigate the association between delivery of a SGA infant and maternal risk for IHD in relation to traditional IHD risk factors. Methods and Findings: Risk of maternal IHD was evaluated in a population based cross-sectional study of 6,608 women with a prior live term birth who participated in the National Health and Nutrition Examination Survey (1999-2006), a probability sample of the U.S. population. Sequence of events was determined from age at last live birth and at diagnosis of IHD. Delivery of a SGA infant is strongly associated with greater maternal risk for IHD (age adjusted OR; 95% CI: 1.8; 1.2, 2.9; p = 0.012). The association was independent of the family history of IHD, stroke, hypertension and diabetes (family history-adjusted OR; 95% CI: 1.9; 1.2, 3.0; p = 0.011) as well as other risk factors for IHD (risk factor-adjusted OR; 95% CI: 1.7; 1.1, 2.7; p = 0.025). Delivery of a SGA infant was associated with earlier onset of IHD and preceded it by a median of 30 (interquartile range: 20, 36) years. Conclusions: Giving birth to a SGA infant is strongly and independently associated with IHD and a potential risk factor that precedes IHD by decades. A pregnancy that produces a SGA infant may induce long-term cardiovascular changes that increase risk for IHD.