FETAL AND INFANT GROWTH AND CARDIOVASCULAR RISK-FACTORS IN WOMEN

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.