MOTHERS WEIGHT IN PREGNANCY AND CORONARY HEART-DISEASE IN A COHORT OFFINNISH MEN - FOLLOW-UP-STUDY

Objective: To determine whether restricted growth in utero is associat ed with an increased risk of coronary heart disease among men in Finla nd, where rates of the disease are among the highest in the world. Des ign: Follow up study. Setting: Helsinki, Finland. Subjects: 3302 men b orn in Helsinki University Central Hospital during 1924-33 who went to school in the city of Helsinki and were resident in Finland in 1971. Main outcome measures: Standardised mortality ratios for coronary hear t disease. Results: Men who were thin at birth, with low placental wei ght, had high death rates from coronary heart disease. Men whose mothe rs had a high body mass index in pregnancy also had high death rates. In a multivariate analysis the hazard ratio for coronary heart disease was 1.37 (95% confidence interval 1.20 to 1.57) (P < 0.0001) for ever y standard deviation decrease in ponderal index at birth and 1.24 (1.1 0 to 1.39) (P = 0.0004) for every standard deviation increase in mothe r's body mass index. The effect of mother's body mass index was restri cted to mothers of below average stature. Conclusion: These findings s uggest a new explanation for the epidemics of coronary heart disease t hat accompany Westernisation. Chronically malnourished women are short and light and their babies tend to be thin. The immediate effect of i mproved nutrition is that women become fat, which seems to increase th e risk of coronary heart disease in the next generation. With continue d improvements in nutrition, women become taller and heavier; their ba bies are adequately nourished; and maternal fatness no longer increase s the risk of coronary heart disease, which therefore declines.