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BMJ No 7105 Volume 315 Papers - Abstracts Saturday 16 August 1997
Birth weight and risk of cardiovascular disease in a cohort of
women followed up since 1976
Birth weight and risk of cardiovascular disease in a cohort of women followed up since 1976Janet W Rich-Edwards, Meir J Stampfer, JoAnn E Manson, Bernard Rosner, Susan E Hankinson, Graham A Colditz, Walter C Willett, Charles H Hennekens
AbstractObjective: To examine the association between birth weight and non-fatal adult cardiovascular disease while controlling for potential confounders such as socioeconomic group and adult lifestyle.Design: Retrospective self report of birth weight in an ongoing longitudinal cohort of nurses followed up by postal questionnaire every two years. Setting: Nurses' health study, a cohort of 121,700 women followed up since 1976. Main outcome measures: Non-fatal cardiovascular disease, including myocardial infarction, coronary revascularisation, and stroke. Results: Among the 70,297 women free of cardiovascular disease at baseline who reported birth weight in the 1992 questionnaire there were 1,309 first cases of non-fatal cardiovascular disease. Increasing birth weight was associated with decreasing risk of non-fatal cardiovascular disease. There were 1,216 first cases of non-fatal cardiovascular disease among women who were singletons and had been born full term; their relative risks adjusted for several cardiovascular risk factors were 1.49 (95% confidence interval 1.05 to 2.10) for birth weight <2268 g (<5 lb 0 oz); 1.25 (0.98 to 1.61) for birth weight 2268-2495 g (5 lb 0 oz to 5 lb 8 oz); 1.12 (0.98 to 1.27) for birth weight >2495-3175 g (>5 lb 8 oz to 7 lb 0 oz); 1.00 (referent) for birth weight >3175-3856 g (>7 lb 0 oz to 8 lb 8 oz); 0.96 (0.80 to 1.15) for birth weight >3856-4536 g (>8 lb 8 oz to 10 lb 0 oz); and 0.68 (0.46 to 1.00) for birth weight >4536 g (>10 lb 0 oz) (P value for trend=0.0004). The inverse trend was apparent for both coronary heart disease and stroke. Conclusions: These data provide strong evidence of an association between birth weight and adult coronary heart disease and stroke. Department of Medicine, Division of Preventive Medicine
Channing
Laboratory
Department of Nutrition, Correspondence to: Dr J W Rich-Edwards
Department of Ambulatory Care and Prevention, (nhjre@gauss.bwh.harvard.edu).
Birth weight and cognitive function in young adult life: historical cohort studyHenrik Toft Sørensen, Svend Sabroe, Jørn Olsen, Kenneth J Rothman, Matthew W Gillman, Peer Fischer AbstractObjective: To examine the relation between birth weight and cognitive function in young adult life.Design: Retrospective cohort study based on birth registry data and cognitive function measured during evaluation for military service. Subjects: 4,300 Danish conscripts born between 1973 and 1975. Main outcome measures: Mean score in the Boerge Prien test of cognitive function; score is the number of correct answers to 78 questions and correlates with full scale intelligence quotient (IQ). Results: Mean score in the Boerge Prien test increased from 39.9 at a birth weight of 2500 g and under to 44.6 at a birth weight of 4200 g even after adjustment for gestational age and length at birth, maternal age and parity, and other variables. Above a birth weight of 4200 g the test score decreased slightly. Conclusion: Birth weight is associated with cognitive performance in young adult life. Interference with fetal growth may influence adult cognitive performance. Department of Internal
Medicine V, Danish Epidemiology Science Centre, Department of Epidemiology and Preventive Medicine, Department of Ambulatory Care and Prevention, Conscription Administration, Correspondence to: Dr Toft Sørensen (HTS@soci.aau.dk).
Is histological examination of tissue removed by general practitioners always necessary? Before and after comparison of detection rates of serious skin lesionsAdam Lowy, Diane Willis, Keith Abrams AbstractObjectives: To examine whether histological examination of all tissue removed by general practitioners in minor surgery increases the rate of detection of clinically important skin lesions, and to assess the impact of such a policy on pathologists' workload.Design: Before and after comparison. Setting: Stratified random sample of 257 general practitioner partnerships from the catchment areas of 19 English pathology laboratories. Subjects: Tissue removed in minor surgery by general practitioners during the control period (September 1992 to February 1993) and intervention period (September 1993 to February 1994). Intervention: General practitioners referred to their local pathology laboratory all solid tissue removed in all minor surgery, irrespective of their previous policy. Main outcome measures: Numbers of specimens referred for histology by general practitioners during intervention and control periods; numbers of primary malignant melanomas, non-melanoma malignancies, premalignant lesions, and benign lesions. Results: 257/330 partnerships participated (response rate 78%). During the intervention period 5723 specimens were sent, compared with 4430 during the control period. The referral rate increased by an estimated 1.34 specimens per 1,000 patient years (95% confidence interval 0.93 to 1.76, P<0.001). General practitioners sent 204 specimens that were malignant (including 16 malignant melanomas) in the control period and 188 that were malignant (including 15 malignant melanomas) during the intervention period (change in total number of malignancies, -1.0 per 100,000 patient years (-5.9 to 3.8, non-significant). Conclusions: The intervention was associated with a substantial increase in laboratory workload, all of which was accounted for by increases in non-serious lesions. This observation should be taken into account when considering the merits of a policy requiring histological examination in every case. Department of Epidemiology and
Public Health, Greenwood Institute for Child
Health, Correspondence to: Dr Lowy Home | Current contents | Past issues | Classified ads | Career Focus | Feedback Collections | About this site | About the BMJ | BMA | Medline
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