CARDIOVASCULAR MEDICINE

Growth of girls who later develop coronary heart disease

T Forsén², C Osmond¹, J G Eriksson², D J P Barker¹

¹ Southampton General Hospital, Tremona Road, Southampton, UK
² National Public Health Institute, Helsinki, Finland

Correspondence to:
Correspondence to:
Professor D J P Barker
Southampton General Hospital, Tremona Road, Southampton SO16 6YD, UK; djpb{at}mrc.soton.ac.uk

Objective: To determine the path of growth of girls who later develop coronary heart disease.

Design: Follow up study of girls whose body size at birth, during infancy, and childhood up to age 12 years was recorded.

Setting: Helsinki, Finland.

Participants: 4130 girls who were born between 1934 and 1944, attended child welfare clinics in Helsinki, and were still resident in Finland in 1971.

Main outcome measure: Hospital admission or death from coronary heart disease.

Results: In comparison with boys in the same cohort who later developed coronary heart disease the 87 girls were short at birth, rather than thin, had compensatory growth in height during infancy, became thin, and thereafter had a rapid increase in weight and body mass index. In a combined analysis the hazard ratios for coronary heart disease were 1.17 (95% confidence interval (CI) 1.03 to 1.32, p = 0.02) for each 1 cm decrease in length at birth, 1.52 (95% CI 1.23 to 1.89, p < 0.001) for each standard deviation score increase in body mass index after age 3 years, and 1.63 (95% CI 1.09 to 2.42, p = 0.02) for each decrease in level of education.

Conclusions: Though broadly similar, the paths of growth associated with the later development of coronary heart disease differ in girls and boys. This may be because girls are less vulnerable to undernutrition in utero and are better able to sustain postnatal growth in an adverse environment.

Keywords: childhood growth; coronary heart disease; fetal origins; women

Abbreviations: CI, confidence interval; ICD, international classification of diseases

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