Objective-To examine whether cardiovascular risk factors in women are
related to fetal and infant growth. Design-Follow up study of women bo
rn 1923-30 whose birth weights and weights at one year were recorded.
Setting-Hertfordshire. Subjects-297 women born and still living in Eas
t Hertfordshire. Main outcome measures-Plasma glucose and insulin conc
entrations during a standard oral glucose tolerance test; fasting plas
ma proinsulin and 32-33 split proinsulin concentrations; blood pressur
e; fasting serum total, low density lipoprotein and high density lipop
rotein cholesterol, triglyceride, and apolipoprotein A I and B concent
rations; and plasma fibrinogen and factor VII concentrations. Results-
Fasting plasma concentrations of glucose, insulin, and 32-33 split pro
insulin fell with increasing birth weight (P=0.04, P-0.002, and P=0.00
02 respectively, when current body mass index was allowed for). Glucos
e and insulin concentrations 120 minutes after an oral glucose load sh
owed similar trends (P=0.03 and P=0.02). Systolic blood pressure, wais
t:hip ratio, and serum triglyceride concentrations also fell with incr
easing birth weight (P=0.08, P=0.07, and P=0.07 respectively), while s
erum high density lipoprotein cholesterol concentrations rose (P=0.04)
. At each birth weight women who currently had a higher body mass inde
x had higher levels of risk factors. Conclusion-In women, as in men, r
educed fetal growth leads to insulin resistance and the associated dis
orders: raised blood pressure and high serum triglyceride and low seru
m high density lipoprotein cholesterol concentrations. The highest val
ues of these coronary risk factors occur in people who were small at b
irth and become obese. In contrast with men, low rates of infant growt
h did not predict levels of risk factors in women.