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Sánchez-Soriano C, Pearson ER, Reynolds RM. Associations of offspring birthweight and placental weight with subsequent parental coronary heart disease: survival regression using the walker cohort. J Dev Orig Health Dis 2023; 14:746-754. [PMID: 38192014 DOI: 10.1017/s2040174423000430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2024]
Abstract
Low birth weight (BW) is consistently correlated with increased parental risk of subsequent cardiovascular disease, but the links with offspring placental weight (PW) are mostly unexplored. We have investigated the associations between parental coronary heart disease (CHD) and offspring BW and PW using the Walker cohort, a collection of 48,000 birth records from Dundee, Scotland, from the 1950s and 1960s. We linked the medical history of 13,866 mothers and 8,092 fathers to their offspring's records and performed Cox survival analyses modelling maternal and paternal CHD risk by their offspring's BW, PW, and the ratio between both measurements. We identified negative associations between offspring BW and both maternal (hazard ratio [HR]: 0.91, 95% confidence interval [CI]: 0.88-0.95) and paternal (HR: 0.96, 95% CI: 0.93-1.00) CHD risk, the stronger maternal correlation being consistent with previous reports. Offspring PW to BW ratio was positively associated with maternal CHD risk (HR: 1.14, 95% CI: 1.08-1.21), but the associations with paternal CHD were not significant. These analyses provide additional evidence for intergenerational associations between early growth and parental disease, identifying directionally opposed correlations of maternal CHD with offspring BW and PW, and highlight the importance of the placenta as a determinant of early development and adult disease.
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Affiliation(s)
- Carlos Sánchez-Soriano
- Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - Ewan R Pearson
- Division of Population Health and Genomics, Ninewells Hospital and School of Medicine, University of Dundee, Dundee, UK
| | - Rebecca M Reynolds
- Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
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2
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Harville EW, Wallace ME, He H, Bazzano LA. Lifetime cardiovascular risk factors and maternal and offspring birth outcomes: Bogalusa Babies. PLoS One 2022; 17:e0260703. [PMID: 35081112 PMCID: PMC8791492 DOI: 10.1371/journal.pone.0260703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 11/15/2021] [Indexed: 11/24/2022] Open
Abstract
Both cardiovascular and reproductive complications may have origins in utero or in early life. Women in the Bogalusa Heart Study (n = 1401) had been linked to birth certificates for birthweight and gestational data, which were examined relative to childhood (ages 4–16) cardiometabolic indicators, indicated by mean levels overall and total risk factor burden as estimated by area under the curve (AUC) computed from longitudinal quadratic random-effects growth models. Women reported the birthweight and gestational age of each of their own pregnancies, and delivery medical records were linked to interview data where possible. Path analyses were conducted to examine the relationships among a woman’s own birth outcomes, childhood and preconception adult cardiovascular health, and birth outcomes. Mean blood pressure (systolic blood pressure (SBP) adjusted relative risk (aRR) per 1-SD increase, 1.27, 95% CI 1.04–1.57) and low-density lipoprotein (aRR 1.21, 95% CI 1.02–1.44) in childhood predicted preterm birth (PTB), while mean SBP (aRR 1.33, 95% CI 1.02–1.74) predicted term low birthweight. The AUC data suggested an association between blood pressure and PTB (aRR for SBP top 10%, 1.86, 95% CI 1.08–3.21). Pre-pregnancy total cholesterol was negatively associated with gestational age. In path analyses, positive associations were found for each step between own birthweight, childhood BMI, pre-pregnancy BMI, and child’s birthweight. Childhood levels of some, though not all, cardiovascular risk factors may predict adverse birth outcomes (preterm birth and reduced fetal growth).
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Affiliation(s)
- Emily W. Harville
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, United States of America
- * E-mail:
| | - Maeve E. Wallace
- Department of Global Community Health and Behavior, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, United States of America
| | - Hua He
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, United States of America
| | - Lydia A. Bazzano
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, United States of America
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3
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Haug EB, Markovitz AR, Fraser A, Dalen H, Romundstad PR, Åsvold BO, Rich-Edwards JW, Horn J. The role of cardiovascular risk factors in maternal cardiovascular disease according to offspring birth characteristics in the HUNT study. Sci Rep 2021; 11:22981. [PMID: 34837029 PMCID: PMC8626478 DOI: 10.1038/s41598-021-99478-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 09/14/2021] [Indexed: 11/22/2022] Open
Abstract
A history of preterm or small (SGA) or large (LGA) for gestational age offspring is associated with smoking and unfavorable levels of BMI, blood pressure, glucose and lipids. Whether and to what extent the excess cardiovascular risk observed in women with these pregnancy complications is explained by conventional cardiovascular risk factors (CVRFs) is not known. We examined the association between a history of SGA, LGA or preterm birth and cardiovascular disease among 23,284 parous women and quantified the contribution of individual CVRFs to the excess cardiovascular risk using an inverse odds weighting approach. The hazard ratios (HR) between SGA and LGA offspring and CVD were 1.30 (95% confidence interval (CI) 1.15, 1.48) and 0.89 (95% CI 0.76, 1.03), respectively. Smoking explained 49% and blood pressure may have explained ≈12% of the excess cardiovascular risk in women with SGA offspring. Women with preterm birth had a 24% increased risk of CVD (HR 1.24, 95% CI 1.06, 1.45), but we found no evidence for CVRFs explaining any of this excess cardiovascular risk. While smoking explains a substantial proportion of excess cardiovascular risk in women with SGA offspring and blood pressure may explain a small proportion in these women, we found no evidence that conventional CVRFs explain any of the excess cardiovascular risk in women with preterm birth.
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Affiliation(s)
- Eirin B Haug
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, K.G. Jebsen Center for Genetic Epidemiology, NTNU, Norwegian University of Science and Technology, Postboks 8905, 7491, Trondheim, Norway.
- Department of Population Health Sciences, Bristol Medical School and MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK.
| | - Amanda R Markovitz
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
- Division of Women's Health, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
- Mathematica, Cambridge, MA, USA
| | - Abigail Fraser
- Department of Population Health Sciences, Bristol Medical School and MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
| | - Håvard Dalen
- Department of Medicine, Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
- Department of Circulation and Medical Imaging, NTNU, Norwegian University of Science and Technology, Trondheim, Norway
- Clinic of Cardiology, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Pål R Romundstad
- Department of Public Health and Nursing, NTNU, Norwegian University of Science and Technology, Trondheim, Norway
| | - Bjørn O Åsvold
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, K.G. Jebsen Center for Genetic Epidemiology, NTNU, Norwegian University of Science and Technology, Postboks 8905, 7491, Trondheim, Norway
- Department of Endocrinology, Clinic of Medicine, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Janet W Rich-Edwards
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
- Division of Women's Health, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Julie Horn
- Department of Public Health and Nursing, NTNU, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Obstetrics and Gynecology, Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
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Abstract
Purpose of Review To review the effects of early-life, preconception, and prior-generation exposures on reproductive health in women. Recent Findings Women’s early-life factors can affect reproductive health by contributing to health status or exposure level on entering pregnancy. Alternately, they can have permanent effects, regardless of later-life experience. Nutrition, social class, parental smoking, other adverse childhood experiences, environmental pollutants, infectious agents, and racism and discrimination all affect reproductive health, even if experienced in childhood or in utero. Possible transgenerational effects are now being investigated through three- or more-generation studies. These effects occur with mechanisms that may include direct exposure, behavioral, endocrine, inflammatory, and epigenetic pathways. Summary Pregnancy is increasingly understood in a life course perspective, but rigorously testing hypotheses on early-life effects is still difficult. In order to improve the health outcomes of all women, we need to expand our toolkit of methods and theory. Supplementary Information The online version contains supplementary material available at 10.1007/s40471-021-00279-0.
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Hossin MZ, Falkstedt D, Allebeck P, Mishra G, Koupil I. Early life programming of adult ischemic heart disease within and across generations: The role of the socioeconomic context. Soc Sci Med 2021; 275:113811. [PMID: 33713928 DOI: 10.1016/j.socscimed.2021.113811] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 01/22/2021] [Accepted: 02/27/2021] [Indexed: 12/18/2022]
Abstract
BACKGROUND The developmental origins of ischemic heart disease (IHD) have been widely documented but little is known about their persistence across more than one generation. This study aimed to investigate whether the effects of early life disadvantages on adult IHD have changed between generations and are mediated by adult socioeconomic circumstances, and further explore the transgenerational effects of grandparental and parental exposures to disadvantaged circumstances on adult offspring's IHD. METHODS We used register-based data from the Uppsala Multigenerational Study, Sweden. The study populations were the parents born 1915-1929 and their offspring born 1932-1972 with available obstetric data. The offspring were further linked to grandparents who had their socioeconomic and demographic data recorded. The outcome was incident IHD assessed at ages 32-75 during a follow-up from January 1, 1964 till December 31, 2008. The exposures included birthweight standardized-for-gestational age, ponderal index, gestational length, and parental socioeconomic position (SEP). Education and income were analyzed as mediators. Potential transgenerational associations were explored by linking offspring IHD to parents' standardized birthweight and gestational length, grandparental SEP, and to grandmothers' age, parity, and marital status at parental birth. All associations were examined in Cox proportional hazard regression models. RESULTS Lower standardized birthweight and lower parental SEP were found to be associated with higher IHD rates in both generations, with no evidence of effect modification by generation. Education and income did not mediate the association between standardized birthweight and IHD. Disadvantaged grandparental SEP, younger and older childbearing ages of grandmothers, and paternal preterm birth affected offspring's IHD independent of parental education, income, or IHD history. CONCLUSIONS The findings point to similar magnitudes of IHD inequalities by early life disadvantages across two historical periods and the existence of transgenerational effects on IHD. Epigenetic dysregulation involving the germline is a plausible candidate mechanism underlying the transgenerational associations that warrant further research.
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Affiliation(s)
| | - Daniel Falkstedt
- Department of Global Public Health, Karolinska Institute, Stockholm, Sweden.
| | - Peter Allebeck
- Department of Global Public Health, Karolinska Institute, Stockholm, Sweden.
| | - Gita Mishra
- School of Public Health, The University of Queensland, Herston, Australia.
| | - Ilona Koupil
- Department of Global Public Health, Karolinska Institute, Stockholm, Sweden; Department of Public Health Sciences, Stockholm University, Stockholm, Sweden.
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6
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Jawaid A, Jehle KL, Mansuy IM. Impact of Parental Exposure on Offspring Health in Humans. Trends Genet 2020; 37:373-388. [PMID: 33189388 DOI: 10.1016/j.tig.2020.10.006] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 10/12/2020] [Accepted: 10/16/2020] [Indexed: 12/11/2022]
Abstract
The possibility that parental life experiences and environmental exposures influence mental and physical health across generations is an important concept in biology and medicine. Evidence from animal models has established the existence of a non-genetic mode of inheritance. This form of heredity involves transmission of the effects of parental exposure to the offspring through epigenetic changes in the germline. Studying the mechanisms of epigenetic inheritance in humans is challenging because it is difficult to obtain multigeneration cohorts, to collect reproductive cells in exposed parents, and to exclude psychosocial and cultural confounders. Nonetheless, epidemiological studies in humans exposed to famine, stress/trauma, or toxicants have provided evidence that parental exposure can impact the health of descendants, in some cases, across several generations. A few studies have also started to reveal epigenetic changes in the periphery and sperm after certain exposures. This article reviews these studies and evaluates the current evidence for the potential contribution of epigenetic factors to heredity in humans. The challenges and limitations of this fundamental biological process, its implications, and its societal relevance are also discussed.
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Affiliation(s)
- Ali Jawaid
- Laboratory of Neuroepigenetics, Brain Research Institute, Medical Faculty of the University of Zurich, Zürich, Switzerland; Institute for Neuroscience, Department of Health Science and Technology of the Swiss Federal Institute of Technology (ETH), Zürich, Switzerland; BRAINCITY EMBL-Nencki Center of Excellence for Neural Plasticity and Brain Disorders, Nencki Institute of Experimental Biology, Warsaw, Poland; Department of Neurology, University of Texas Health Science Center, Houston, TX, USA
| | | | - Isabelle M Mansuy
- Laboratory of Neuroepigenetics, Brain Research Institute, Medical Faculty of the University of Zurich, Zürich, Switzerland; Institute for Neuroscience, Department of Health Science and Technology of the Swiss Federal Institute of Technology (ETH), Zürich, Switzerland.
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7
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Life Course Trajectories of Maternal Cardiovascular Risk Factors according to Offspring Birthweight: The HUNT Study. Sci Rep 2020; 10:10436. [PMID: 32591565 PMCID: PMC7319986 DOI: 10.1038/s41598-020-66365-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Accepted: 05/19/2020] [Indexed: 12/02/2022] Open
Abstract
Women with small or large for gestational age offspring are at increased risk of cardiovascular disease later in life. How their cardiovascular risk factors develop across the life course is incompletely known. We linked data from the population-based HUNT Study (1984–2008) and the Medical Birth Registry of Norway (1967–2012) for 22,487 women. Mixed effect models were used to compare cardiovascular risk factor trajectories for women according to first offspring birthweight for gestational age. Women with small for gestational age (SGA) offspring had 1–2 mmHg higher systolic and diastolic blood pressure across the life course, but lower measures of adiposity, compared to women with offspring who were appropriate for gestational age (AGA). In contrast, women with large for gestational age (LGA) offspring had higher measures of adiposity, ~0.1 mmol/l higher non-HDL cholesterol and triglycerides and 0.2 mmol/l higher non-fasting glucose, compared with mothers of AGA offspring. These differences were broadly stable from prior to first pregnancy until 60 years of age. Our findings point to different cardiovascular risk profiles in mothers of SGA versus LGA offspring, where giving birth to SGA offspring might primarily reflect adverse maternal vascular health whereas LGA offspring might reflect the mother’s metabolic health.
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Shaikh F, Kjølllesdal MK, Carslake D, Stoltenberg C, Davey Smith G, Næss Ø. Birthweight in offspring and cardiovascular mortality in their parents, aunts and uncles: a family-based cohort study of 1.35 million births. Int J Epidemiol 2020; 49:205-215. [PMID: 31325357 PMCID: PMC7124506 DOI: 10.1093/ije/dyz156] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/04/2019] [Indexed: 11/26/2022] Open
Abstract
Background A link between suboptimal fetal growth and higher risk of cardiovascular disease (CVD) is well documented. It has been difficult to assess the contribution of environmental versus genetic factors to the association, as these factors are closely connected in nuclear families. We investigated the association between offspring birthweight and CVD mortality in parents, aunts and uncles, and examined whether these associations are explained by CVD risk factors. Methods We linked Norwegian data from the Medical Birth Registry, the Cause of Death Registry and cardiovascular surveys. A total of 1 353 956 births (1967–2012) were linked to parents and one maternal and one paternal aunt/uncle. Offspring birthweight and CVD mortality association among all relationships was assessed by hazard ratios (HR) from Cox regressions. The influence of CVD risk factors on the associations was examined in a subgroup. Results Offspring birthweight was inversely associated with CVD mortality among parents and aunts/uncles. HR of CVD mortality for one standard deviation (SD) increase in offspring birthweight was 0.72 (0.69–0.75) in mothers and 0.89 (0.86–0.92) in fathers. In aunts/uncles, the HRs were between 0.90 (0.86–0.95) and 0.93 (0.91–0.95). Adjustment for CVD risk factors in a subgroup attenuated all the associations. Conclusions Birthweight was associated with increased risk of CVD in parents and in aunts/uncles. These associations were largely explained by CVD risk factors. Our findings suggest that associations between offspring birthweight and CVD in adult relatives involve both behavioural variables (especially smoking) and shared genetics relating to established CVD risk factors.
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Affiliation(s)
- Fareeha Shaikh
- Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
| | | | - David Carslake
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK.,Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Camilla Stoltenberg
- Norwegian Institute of Public Health, Oslo, Norway.,Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - George Davey Smith
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK.,Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Øyvind Næss
- Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway.,Norwegian Institute of Public Health, Oslo, Norway
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9
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The association between birthweight and grandparental type 2 diabetes and cardiovascular disease in a multiethnic population. J Dev Orig Health Dis 2019; 11:403-409. [PMID: 31735184 DOI: 10.1017/s2040174419000758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Intergenerational links of chronic disease have been suggested, as birthweight (BW) is associated with cardiovascular disease (CVD) and type 2 diabetes (T2D) in both parents and grandparents. However, most studies investigating these relationships have used relatively homogenous, white, majority populations. This study aimed to investigate the association between BW and CVD and T2D in a multiethnic population, that is, where the parents and grandparents often developed in a different environment from that where the child was born. Participants were women from a population-based cohort study of pregnant women (STORK Groruddalen), attending Child Health Clinics for antenatal care in three administrative city districts in Oslo, Norway, 2008-2010. Information about socioeconomic and lifestyle factors were collected among mothers and fathers. Parents reported history of CVD or T2D among grandparents. In logistic regressions, higher BW z-scores were associated with lower odds of T2D among maternal (OR 0.71 (95% CI 0.53, 0.97) and paternal (0.68 (0.49, 0.94) grandmothers after adjustments for parental and grandmothers' characteristics. BW was not associated with CVD, but the association in maternal grandfathers was borderline significant. Our results indicate intergenerational transmission of chronic diseases like T2D in a multiethnic population.
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10
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Abstract
OBJECTIVE The Developmental Origins of Disease hypothesis has spurred increased interest in how prenatal exposures affect lifelong health, while mechanisms such as epigenetics may explain the multigenerational influences on health. Such factors are not well captured within conventional epidemiologic study designs. We explored the feasibility of collecting information on the offspring and grand-offspring of participants in a long-running study. DESIGN The Bogalusa Heart Study is a study, begun in 1973, of life-course cardiovascular health in a semirural population (65% white and 35% black). MAIN MEASURES Female participants who had previously provided information on their pregnancies were contacted to obtain contact information for their daughters aged 12 and older. Daughters were then contacted to obtain reproductive histories, and invited for a clinic or lab visit to measure cardiovascular risk factors. RESULTS Two hundred seventy-four daughters of 208 mothers were recruited; 81% (223) had a full clinic visit and 19% (51) a phone interview only. Forty-five percent of the daughters were black, and 55% white. Mean and median age at interview was 27, with 15% under the age of 18. The strongest predictors of participation were black race, recent maternal participation in the parent study, and living in or near Bogalusa. Simple correlations for cardiovascular risk factors across generations were between r = 0.19 (systolic blood pressure) and r = 0.39 (BMI, LDL). CONCLUSION It is feasible to contact the children of study participants even when participants are adults, and initial information on the grandchildren can also be determined in this manner.
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11
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Lai Y, Qi J, Tao X, Huang K, Yan S, Chen M, Hao J, Tao F. Associations of grandparental diabetes mellitus with grandchild BMI status. BMC Public Health 2019; 19:172. [PMID: 30744597 PMCID: PMC6371523 DOI: 10.1186/s12889-019-6485-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Accepted: 01/25/2019] [Indexed: 12/19/2022] Open
Abstract
Background Maternal family history of diabetes was significantly and positively associated with birth weight in grandchildren, we aim to assess the effect of grandparental diabetes on the grandchild’ body mass index (BMI) at infancy peak (IP) and obesity status at age 2. Methods In our study, family diabetes mellitus (DM) information from Ma’anshan Birth Cohort Study (MABC) were gathered. For children, height and weight were retrieved from medical records. BMI at 6 observations (0, 3, 6, 9, 12, 18 months) was plotted for every child. Onset of IP was determined by visual inspection. BMI at age 2 was categorized according to WHO Child Growth Standards as normal, overweight or obesity. The association between maternal grandfather’ diabetes and the grandchild’ BMI at IP and BMI at age 2 were tested using linear regression models and logistic regression models, respectively. Results In our sample, about 6% of the maternal grandfather had DM, mean of infancy BMI peak was 18.37 kg/m2, and 6.6% of the children were obesity at age 2. Maternal grandfather with DM could significantly increase the IP BMI values (β = 0.30, 95 CI = 0.02~0.57), and was associated with obesity status at age 2 (OR = 1.92, 95 CI = 1.08~3.39), but maternal grandmother and paternal grandparents were unrelated. Conclusion These results suggest that DM in maternal grandfather may be a risk factor for the grandchild high BMI at peak and obesity at age 2.
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Affiliation(s)
- Yaping Lai
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Juan Qi
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Xingyong Tao
- Anhui Provincial Key Laboratory of Population Health & Aristogenics, Hefei, China.,Teaching Center of Preventive Medicine, School of Public Health, Anhui Medical University, Hefei, China
| | - Kun Huang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China.,Anhui Provincial Key Laboratory of Population Health & Aristogenics, Hefei, China
| | - Shuangqin Yan
- Ma'anshan Maternal and Child Health (MCH) Center, Ma'anshan, China
| | - Maolin Chen
- Ma'anshan Maternal and Child Health (MCH) Center, Ma'anshan, China
| | - Jiahu Hao
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China.,Anhui Provincial Key Laboratory of Population Health & Aristogenics, Hefei, China
| | - Fangbiao Tao
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China. .,Anhui Provincial Key Laboratory of Population Health & Aristogenics, Hefei, China.
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12
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Harville EW, Apolzan JW, Bazzano LA. Maternal Pre-Pregnancy Cardiovascular Risk Factors and Offspring and Grandoffspring Health: Bogalusa Daughters. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 16:E15. [PMID: 30577626 PMCID: PMC6338978 DOI: 10.3390/ijerph16010015] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Revised: 12/10/2018] [Accepted: 12/19/2018] [Indexed: 12/16/2022]
Abstract
Both maternal pre-pregnancy body mass index (BMI) and gestational weight gain have been associated with cardiovascular health in the offspring beyond two generations. A total of 274 daughters (aged 12⁻54) of 208 mothers who participated in the Bogalusa Heart Study were interviewed about their reproductive history. Mothers' data was taken from the original study, and cardiovascular measures at the visit prior to pregnancy were correlated with daughter's measures. Maternal pre-pregnancy BMI, skinfold, and waist circumference were examined as a predictor of daughters' blood pressure, lipids, and glucose, as well as a predictor of birthweight and gestational age of grandchildren. Maternal pre-pregnancy BMI was associated with higher blood pressure and lower low-density lipoprotein (LDL) and cholesterol in the daughters. Most maternal cardiometabolic risk factors were not associated with grandchildren's birth outcomes, even though higher cholesterol and LDL was associated with lower gestational age, and higher BMI and skinfold thickness with an increased risk of preterm birth. In this pilot study, some associations were found between maternal adiposity and cardiovascular risk, daughters' cardiovascular risk, and grandchild birth outcomes. Lack of conclusive associations could be due to a true lack of effect, effects being primarily mediated through daughter's BMI, or the low power of the study.
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Affiliation(s)
- Emily W Harville
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA 70112, USA.
| | - John W Apolzan
- Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA 70808, USA.
| | - Lydia A Bazzano
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA 70112, USA.
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13
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Offspring birth weight and cardiovascular mortality among parents: the role of cardiovascular risk factors. J Dev Orig Health Dis 2018; 9:351-357. [DOI: 10.1017/s2040174418000065] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractAn inverse association between offspring birth weight (BW) and higher risk of parental cardiovascular disease (CVD) mortality and morbidity has been reported. Shared environmental, genetic and intrauterine factors may be responsible for explaining these associations. We studied the role of parental CVD risk factors in the association between offspring BW and CVD mortality among mothers and fathers. All births registered in Medical Birth Registry Norway (1967–2012) were linked to three health surveys, National Educational Registry and Cause of Death Registry. Number of births with information of parental CVD risk factors available for the analyses was 1,006,557 (520,670 for mothers and 485,887 for fathers). Cox proportional hazards regression models were used, following CVD deaths in parents from 1974 to 2012. An inverse association between offspring BW and CVD mortality was observed among both parents: hazard ratio 1.60 (1.44–1.75) for mothers and 1.16 (1.10–1.23) for fathers. Among mothers, adjustment for smoking, triglycerides and diabetes reduced the risk to 1.36 (1.25–1.52), 1.57 (1.43–1.73) and 1.58 (1.43–1.79), respectively. Adjustment for diastolic blood pressure (DBP) and systolic blood pressure (SBP) both reduced the risk to 1.53 (1.37–1.66). Among fathers, adjustments for smoking, DBP, SBP reduced the risk to 1.08 (1.02–1.15), 1.13 (1.06–1.19) and 1.14 (1.08–1.22), respectively. Triglycerides and diabetes both reduced the risk to 1.15 (1.09–1.12). Our results indicate that shared environmental factors might be important in the association. A stronger association in mothers suggest that intrauterine factors also are at play.
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Aarnio K, Gissler M, Grittner U, Siegerink B, Kaste M, Tatlisumak T, Tikkanen M, Putaala J. Outcome of pregnancies and deliveries before and after ischaemic stroke. Eur Stroke J 2017; 2:346-355. [PMID: 31008326 DOI: 10.1177/2396987317723795] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2017] [Accepted: 07/07/2017] [Indexed: 11/15/2022] Open
Abstract
Introduction Limited data exist on the outcome of pregnancies and deliveries in women with ischaemic stroke. We investigated the incidence of pregnancy- and delivery-related complications in women with ischaemic stroke before and after pregnancy compared with stroke-free matched controls. Patients and methods Of our 1008 consecutive patients aged 15-49 years with first-ever ischaemic stroke, 1994-2007, we included women with pregnancy data before or after stroke recorded in the Medical Birth Register (MBR) (n = 152), and for them searched stroke-free controls matched by age, parity, year of birth, residential area and multiplicity (n = 608). Data on hospital admissions and deaths (1987-2014) came from national health registries. Poisson regression mixed models allowed comparison of the incidence of complications. Results A total of 124 stroke mothers had 207 singleton pregnancies before and 45 mothers 68 pregnancies after stroke. The incidence rate ratio (IRR) for the composite outcome of pregnancy and delivery complications adjusted for socioeconomic status and maternal smoking was 1.43 (95% confidence interval [CI] 1.00-2.03, p = 0.05) for pre-stroke mothers, and 1.09 (95% CI 0.66-1.78) for post-stroke mothers, compared with matched controls. Similarly, the adjusted IRR for post-stroke hospital admission during pregnancy was 1.85 (95% CI 1.03-3.31). The IRR for perinatal death of the child was 3.43 (95% CI 0.57-20.53) before and 8.88 (95% CI 0.81-97.95) after stroke. Discussion and conclusions Compared with stroke-free mothers, we found a higher incidence of pregnancy- and delivery-related complications in mothers with ischaemic stroke. Larger studies are needed to verify our results.
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Affiliation(s)
- Karoliina Aarnio
- Clinical Neurosciences, Neurology, University of Helsinki, Finland
- Department of Neurology, Helsinki University Hospital, Finland
| | - Mika Gissler
- National Institute for Health and Welfare, Finland
- Karolinska Institute, Sweden
| | - Ulrike Grittner
- Center for Stroke Research Berlin (CSB) Charité Universitätsmedizin Berlin, Germany
- Department of Biostatistics and Clinical Epidemiology, Charité Universitätsmedizin Berlin, Germany
| | - Bob Siegerink
- Center for Stroke Research Berlin (CSB) Charité Universitätsmedizin Berlin, Germany
| | - Markku Kaste
- Clinical Neurosciences, Neurology, University of Helsinki, Finland
- Department of Neurology, Helsinki University Hospital, Finland
| | - Turgut Tatlisumak
- Clinical Neurosciences, Neurology, University of Helsinki, Finland
- Department of Neurology, Helsinki University Hospital, Finland
- Institute of Neurosciences and Physiology, Sahlgrenska Academy, University of Gothenburg, Sweden
- Department of Neurology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Minna Tikkanen
- Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Finland
| | - Jukka Putaala
- Clinical Neurosciences, Neurology, University of Helsinki, Finland
- Department of Neurology, Helsinki University Hospital, Finland
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Predictors of adults' body mass index and the association with index child's infant birth weight, in the Lifeways Cross-Generation Cohort Study of a thousand families in the Republic of Ireland. J Dev Orig Health Dis 2017. [PMID: 28637529 DOI: 10.1017/s2040174417000435] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The Lifeways study is novel in having information on three generations of the same families. It is well established that infant birth weight (IBW) predicts individuals' risk of adult chronic disease and more recently studies report cross-generation transmission of risk patterns. The aims of this analysis were to examine whether adults' birth weights were associated with measures of own health status or social position and to relate adults' birth weights to that of the index child's IBW. Finally, we assessed whether birth weight of either adults or children was associated with adult body mass index (BMI) of parents and grandparents. We included 1075 children whose IBW was recorded at recruitment from hospital records and 2546 adult cohort members followed from 2001 until 2014. At baseline, a sub-group of 920 adults had reported own birth weight (RBW). Results showed male adults' RBW were significantly higher than females' (P=0.001). Mothers' RBW was significantly correlated with IBW (r=0.178, P<0.001). In mixed effects linear models with BMI as the outcome variable, of all adults, and in sub-groups of adults with RBW and of mothers only, the IBW was associated with adult BMI adjusting for other predictors. Adults' BMI was positively associated with age (P=0.013), index child's IBW (P=0.001), gender (P<0.001) but not own RBW, adjusting for family identification number. When mothers were removed from the adult models however, IBW ceased to be associated with BMI, a final model showed RBW being associated with adult BMI (P=0.04). There are cross-generational associations in the Lifeways cohort, the maternal association being stronger.
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16
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Raju TNK, Pemberton VL, Saigal S, Blaisdell CJ, Moxey-Mims M, Buist S. Long-Term Healthcare Outcomes of Preterm Birth: An Executive Summary of a Conference Sponsored by the National Institutes of Health. J Pediatr 2017; 181:309-318.e1. [PMID: 27806833 DOI: 10.1016/j.jpeds.2016.10.015] [Citation(s) in RCA: 111] [Impact Index Per Article: 15.9] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Revised: 08/17/2016] [Accepted: 10/04/2016] [Indexed: 12/22/2022]
Affiliation(s)
- Tonse N K Raju
- Eunice Kennedy Shriver National Institutes of Child Health and Human Development, National Institutes of Health, Bethesda, MD.
| | | | - Saroj Saigal
- National Heart, Lung, and Blood Institute, Bethesda, MD
| | | | - Marva Moxey-Mims
- National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD
| | - Sonia Buist
- Oregon Health & Sciences University, Portland, OR
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17
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Franks PW, McCarthy MI. Exposing the exposures responsible for type 2 diabetes and obesity. Science 2016; 354:69-73. [DOI: 10.1126/science.aaf5094] [Citation(s) in RCA: 161] [Impact Index Per Article: 20.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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18
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Ludvigsson JF, Håberg SE, Knudsen GP, Lafolie P, Zoega H, Sarkkola C, von Kraemer S, Weiderpass E, Nørgaard M. Ethical aspects of registry-based research in the Nordic countries. Clin Epidemiol 2015; 7:491-508. [PMID: 26648756 PMCID: PMC4664438 DOI: 10.2147/clep.s90589] [Citation(s) in RCA: 245] [Impact Index Per Article: 27.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
National health care registries in the Nordic countries share many attributes, but different legal and ethical frameworks represent a challenge to promoting effective joint research. Internationally, there is a lack of knowledge about how ethical matters are considered in Nordic registry-based research, and a lack of knowledge about how Nordic ethics committees operate and what is needed to obtain an approval. In this paper, we review ethical aspects of registry-based research, the legal framework, the role of ethics review boards in the Nordic countries, and the structure of the ethics application. We discuss the role of informed consent in registry-based research and how to safeguard the integrity of study participants, including vulnerable subjects and children. Our review also provides information on the different government agencies that contribute registry-based data, and a list of the major health registries in Denmark, Finland, Iceland, Norway, and Sweden. Both ethical values and conditions for registry-based research are similar in the Nordic countries. While Denmark, Finland, Iceland, Norway, and Sweden have chosen different legal frameworks, these differences can be resolved through mutual recognition of ethical applications and by harmonizing the different systems, likely leading to increased collaboration and enlarged studies.
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Affiliation(s)
- Jonas F Ludvigsson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden ; Department of Pediatrics, Örebro University Hospital, Örebro, Sweden
| | | | | | - Pierre Lafolie
- Department of Medicine, Clinical Pharmacology Unit, Karolinska Institutet, Stockholm, Sweden ; The Stockholm Regional Ethical Review Board, Karolinska Institutet, Stockholm, Sweden
| | - Helga Zoega
- Center of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavík, Iceland
| | - Catharina Sarkkola
- Genetic Epidemiology Group, Folkhälsan Research Center, Helsinki, Finland
| | | | - Elisabete Weiderpass
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden ; Genetic Epidemiology Group, Folkhälsan Research Center, Helsinki, Finland ; Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, Tromsø, Norway ; The Arctic University of Norway, Tromsø, Norway ; Department of Research, Cancer Registry of Norway, Oslo, Norway
| | - Mette Nørgaard
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
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19
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Kvalvik LG, Skjaerven R, Klungsøyr K, Vollset SE, Haug K. Can 'early programming' be partly explained by smoking? Results from a prospective, population-based cohort study. Paediatr Perinat Epidemiol 2015; 29:50-9. [PMID: 25417973 DOI: 10.1111/ppe.12164] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Numerous studies have focused the association between low birthweight and later disease. Our objective was to study the association between birthweight and later adult smoking and thereby explore a possible mechanism for the association between low birthweight and later adult disease. METHODS We studied associations between birthweight of women (n=247704) born in 1967-1995 and smoking habits at the end of their pregnancy 13-42 years later in a prospective, population-based cohort study from The Medical Birth Registry of Norway. Similarly, the association between birthweight of men (n=194393) and smoking habits of their partners were assessed. Finally, we studied the relation between smoking habits of the participating women and the cause specific death of their mothers (n=222808). RESULTS Twenty per cent of women with birthweight less than 2000 g were adult daily smokers compared with 11% with birthweight 4000-4499 g [relative risk=1.8, 95% confidence interval 1.4, 2.2]. Similarly, we found an association between men's birthweight and their partners smoking habits. Mothers of smoking women had doubled risk of dying from lung cancer and from cardiovascular disease compared with mothers of non-smoking women. CONCLUSIONS Being born with low birthweight is associated with smoking in adulthood. Associations of adult smoking with partners' birthweight and mothers' smoking-related causes of death suggest a shared smoking environment, and may account for some of the established association between birthweight and later cardiovascular disease.
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Affiliation(s)
- Liv Grimstvedt Kvalvik
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
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20
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Tyrrell JS, Yaghootkar H, Freathy RM, Hattersley AT, Frayling TM. Parental diabetes and birthweight in 236 030 individuals in the UK biobank study. Int J Epidemiol 2013; 42:1714-23. [PMID: 24336895 PMCID: PMC3887570 DOI: 10.1093/ije/dyt220] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background The UK Biobank study provides a unique opportunity to study the causes and consequences of disease. We aimed to use the UK Biobank data to study the well-established, but poorly understood, association between low birthweight and type 2 diabetes. Methods We used logistic regression to calculate the odds ratio for participants’ risk of type 2 diabetes given a one standard deviation increase in birthweight. To test for an association between parental diabetes and birthweight, we performed linear regression of self-reported parental diabetes status against birthweight. We performed path and mediation analyses to test the hypothesis that birthweight partly mediates the association between parental diabetes and participant type 2 diabetes status. Results Of the UK Biobank participants, 277 261 reported their birthweight. Of 257 715 individuals of White ethnicity and singleton pregnancies, 6576 had type 2 diabetes, 19 478 reported maternal diabetes (but not paternal), 20 057 reported paternal diabetes (but not maternal) and 2754 participants reported both parents as having diabetes. Lower birthweight was associated with type 2 diabetes in the UK Biobank participants. A one kilogram increase in birthweight was associated with a lower risk of type 2 diabetes (odds ratio: 0.74; 95% CI: 0.71, 0.76; P = 2 × 10−57). Paternal diabetes was associated with lower birthweight (45 g lower; 95% CI: 36, 54; P = 2 × 10−23) relative to individuals with no parental diabetes. Maternal diabetes was associated with higher birthweight (59 g increase; 95% CI: 50, 68; P = 3 × 10−37). Participants’ lower birthweight was a mediator of the association between reported paternal diabetes and participants’ type 2 diabetes status, explaining 1.1% of the association, and participants’ higher birthweight was a mediator of the association between reported maternal diabetes and participants’ type 2 diabetes status, explaining 1.2% of the association. Conclusions Data from the UK Biobank provides the strongest evidence by far that paternal diabetes is associated with lower birthweight, whereas maternal diabetes is associated with increased birthweight. Our findings with paternal diabetes are consistent with a role for the same genetic factors influencing foetal growth and type 2 diabetes.
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Affiliation(s)
- Jessica S Tyrrell
- European Centre for Environment and Human Health, University of Exeter Medical School, Truro, UK, Genetics of Complex Traits, University of Exeter Medical School, Exeter, UK and Molecular Genetics, Wonford Building, University of Exeter Medical School, Exeter, UK
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Edstedt Bonamy AK, Parikh NI. Predicting Women’s Future Cardiovascular Health from Pregnancy Complications. CURRENT CARDIOVASCULAR RISK REPORTS 2013. [DOI: 10.1007/s12170-013-0314-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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22
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Affiliation(s)
- Rachel Huxley
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1300 S 2nd St, Suite 300, Minneapolis, MN 55454, USA
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