Association between offspring size at birth and maternal
cardiovascular disease mortality
Nine large data linkage studies assessed the association between
offspring birthweight/SGA and maternal cardiovascular disease
mortality1, 2, 4, 15-20 and one assessed the
association between delivery of a SGA infant and the occurrence of
maternal CVD3 (table 2). Of the studies reporting on
maternal CVD mortality, two studies demonstrated aHRs of 2.0 and 2.2 for
each 1kg decrease in offspring birthweight15, 18 and
five studies demonstrated aHRs between 0.75 and 0.89 for each 1 SD
increase in offspring birthweight1, 2, 4, 19, 20(table 2). Four studies assessed maternal CVD mortality in relation to
giving birth to a SGA vs AGA infant and reported aHRs between 1.31 –
3.5 among women who gave birth to SGA compared to AGA
infants2-4, 16 (table 2). A large data linkage study
of 812,732 women demonstrated that, compared to women who gave birth to
non-SGA infants, the aHR for first occurrence of CVD among women who
gave birth to moderately SGA infants (birthweight between
3rd – 10th percentile) was 1.36
(95% CI, 1.23 to 1.49) and among women who gave birth to severe SGA
infants (birthweight <3rd centile) was 1.66
(95% CI, 1.47 to 1.87)3 (table 2). That study also
showed a linear increase in aHR for first occurrence of CVD of 1.42
(95% CI, 1.30 to 1.54), 1.65 (95% CI, 1.34 to 2.03) and 2.42 (95% CI,
1.52 to 3.85) for women who gave birth to one SGA infant, two SGA
infants and three SGA infants respectively, compared to women who gave
birth to non-SGA infants3 (table 2). Three studies
were included in the meta-analysis on CVD mortality among women who gave
birth to SGA compared to AGA infants, providing data on 2,584,533
individuals (figure 3) 2, 4, 16. The pooled data shows
a significantly increased CVD mortality among women who gave birth to
SGA infants compared to those who gave birth to AGA infants (RR 1.45,
95% CI 1.40 to 1.52); heterogeneity: Chi2 P 0.48;
I2 = 0%)