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Cerebrovascular and ischemic heart disease in young adults born preterm: a population-based Swedish cohort study
Dept Med, Clin Epidemiol Unit, Karolinska Univ Hosp Solna, Karolinska Inst, Stockholm, Sweden.
Dept Med, Clin Epidemiol Unit, Karolinska Univ Hosp Solna, Karolinska Inst, Stockholm, Sweden.
Dept Med, Clin Epidemiol Unit, Stockholm, Sweden; Dept Womens & Childrens Hlth, Karolinska Univ Hosp Solna, Karolinska Inst, Stockholm, Sweden.
Dept Med Sci, Mol Epidemiol & Sci Life Lab, Uppsala Univ, Uppsala, Sweden.
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2014 (English)In: European Journal of Epidemiology, ISSN 0393-2990, E-ISSN 1573-7284, Vol. 29, no 4, p. 253-260Article in journal (Refereed) Published
Abstract [en]

Preterm birth is associated with overall cardiovascular mortality in young adulthood, but which specific conditions that underlie this association is unknown. We studied mortality and morbidity from cerebrovascular and ischemic heart disease in individuals born preterm. In a nationwide Swedish study, we included 1,306,943 individuals without congenital malformations born between 1983 and 1995, followed from 15 years of age to December 31st, 2010. Of these, 73,489 (5.6 %) were born preterm (< 37 weeks of gestation). Cox proportional hazards regression analysis was used to calculate hazard ratios (HR) with 95 % confidence intervals (CI), after adjusting for maternal characteristics and birth weight for gestational age. Of 955 incident cases of cerebrovascular disease, 58 (6.1 %) occurred in preterm born subjects. The corresponding numbers of ischemic heart disease cases were 180 and 13 (7.2 %), respectively. Birth before 32 weeks was associated with a nearly twofold increased risk of cerebrovascular disease; adjusted HR, (95 % CI) = 1.89 (1.01-3.54) compared to term born individuals, whereas individuals born at 32-36 weeks were not at increased risk. Preterm birth was not associated with later ischemic heart disease; no cases of ischemic heart disease were recorded among those born before 32 weeks and the HR (95 % CI) for those born at 32-36 weeks of gestation was 1.45 (0.81-2.57), compared to term-born individuals. Birth before 32 weeks is associated with increased risk of cerebrovascular disease in young adulthood. Our data suggest that cardiovascular health promotion in follow-up programs after very preterm birth may be beneficial.

Place, publisher, year, edition, pages
Springer, 2014. Vol. 29, no 4, p. 253-260
Keywords [en]
Cerebrovascular disorders, Ischemic heart disease, Preterm birth, Low birth weight
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:oru:diva-56766DOI: 10.1007/s10654-014-9892-5ISI: 000336801600004PubMedID: 24687624Scopus ID: 2-s2.0-84903795474OAI: oai:DiVA.org:oru-56766DiVA, id: diva2:1084049
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2010-0643
Note

Funding Agencies:

MD-PhD program Karolinska Institutet

Swedish Society for Medical Research

European Union 259679

Available from: 2017-03-23 Created: 2017-03-23 Last updated: 2018-09-11Bibliographically approved

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