Infants with lower birthweight may have poorer cardiovascular health in midlife

Lower birthweight appears to carry an increased future risk of developing myocardial infarction (MI) and unhealthy left ventricular (LV) phenotypes, a study has found.

The study included 258,787 White participants (median age 56 years, 61 percent female) from the UK Biobank. Competing risk regression was used to examine the associations of birthweight with the outcomes such as incident MI and mortality (all-cause, cardiovascular disease, ischaemic heart disease, MI) over 7–12 years of longitudinal follow-up.

On the other hand, linear regression was applied to determine the relationship of birthweight with LV mass-to-volume ratio, LV stroke volume, global longitudinal strain, LV global function index, and left atrial ejection fraction.

Results showed a nonlinear inverse relationship between birthweight and incident MI, with the relationship becoming significant below the optimal birthweight threshold of 3.2 kg (subdistribution hazard ratio [HR], 1.15, 95 percent confidence interval [CI], 1.08–1.22; p=6.0×10–5) and attenuation to the null above this threshold.

On further analysis, the effect of birthweight on incident MI risk was mediated by hypertension (8.4 percent), glycated haemoglobin (7.0 percent), C-reactive protein (6.4 percent), high-density lipoprotein (5.2 percent), and high cholesterol (4.1 percent).

There was no significant association seen between birthweight and mortality.

Among participants with cardiovascular magnetic resonance (n=19,314), lower birthweight was linked to adverse LV remodelling (greater concentricity, poorer function).

These findings highlight the potential of birthweight in risk prediction and disease prevention.