MedWire News: Women who give birth to a small for gestational age (SGA) baby have a significantly increased risk for ischemic heart disease (IHD), researchers say in PLoS One.
The elevated risk associated with giving birth to an SGA baby is equivalent to that associated with hypertension and diabetes, say Radek Bukowski (University of Texas, Galveston, USA) and co-authors.
"SGA deliveries could allow for early intervention and prevention for heart disease," commented Bukowski in a press statement. "If this link is proven, doctors could look out for women who deliver smaller than average babies and provide education and preventative care, which would be especially important in resource-poor countries."
The researchers assessed the risk for maternal IHD in 6608 women with a prior live-term birth who participated in the National Health and Nutrition Examination Survey between 1999 and 2006.
Of these women, 309 delivered an SGA infant (defined as live born ≥37 weeks of gestation with a birth weight <2500 g). The relative odds for IHD in these women were almost two-fold higher than in those who gave birth to non-SGA infants, at an odds ratio of 1.8 (9.6 vs 5.7%).
Multivariate analysis revealed that the risk of IHD associated with delivery of an SGA infant was comparable with the strongest risk factors for IHD, hypertension and diabetes, at an adjusted odds ratio of 1.7.
Furthermore, after adjusting for family medical history and known IHD risk factors such as smoking, SGA remained an independent risk factor for IHD, a result that "surprised" the authors, Bukowski said.
Although he admitted that any explanation for the association between IHD risk and giving birth to an SGA infant is speculative, Bukowski suggested that it could be caused by low concentrations of angiogenic factors, such as placental growth factor, being present in maternal circulation.
As placental growth factor has previously been show to stimulate blood-vessel development and repair in the heart, Bukowski proposed that a deficiency in this factor could affect coronary circulation, which leads to IHD later in life.
"If future research confirms birth weight as a solid predictor, we will have a low-cost effective method to improve identification of women at risk and potentially help prevent heart disease decades before women experience trouble," he added.
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