Low birth weight associated with sudden cardiac death at young age
Click Here to Manage Email Alerts
Children born small for gestational age experienced greater relative risk for sudden cardiac death at a young age compared with those born a normal weight, according to data published in the Journal of the American Heart Association.
“Studies have suggested that growth restriction during pregnancy resulting in small for gestational age infants is associated with cardiovascular programming and remodeling, with long-term cardiovascular consequences,” Vilde Waaler Loland, MD, of the department of cardiology at the Copenhagen University Hospital, Denmark, and colleagues wrote. “We found an increased relative risk of sudden cardiac death among small for gestational age infants, with similar trends remaining after direct adjustment for gestational age.
“Furthermore, we wanted to investigate whether there is an association between large for gestational age and risk of sudden cardiac death, because there has been an increase in mean birth weight in Denmark over the past 30 years, and macrosomia (excessive birth weight) and large for gestational age are closely related to the risk of fetal and maternal complications in relation to birth,” the researchers wrote.
The researchers analyzed all people born in Denmark from 1973 to 2008 and all sudden cardiac deaths in Denmark from 2000 to 2009. The aim was to determine whether birth weight, small for gestational age and large for gestational age are associated with risk for sudden cardiac death among individuals aged 1 to 36 years.
Birth weight and risk for sudden cardiac death
The analysis included 2,234,501 individuals and 389 cases of sudden cardiac death.
Researchers observed that, at age 5 years, individuals born small for gestational age (1,500-2,499 g) experienced greater risk for sudden cardiac death compared with a reference group of individuals who weighed 2,500 g to 3,400 g at birth (RR = 6.69; 95% CI, 2.38-18.8; P < .001).
At age 10 years, risk for sudden cardiac death among individuals who were small for gestational age was still higher compared with those of appropriate weight for gestational age (RR = 2.85; 95% CI, 1.35-6; P = .006). Individuals who were large for gestational age ( 4,500 g) also had greater risk for sudden cardiac death compared with the reference group (RR = 5.89; 95% CI, 1.81-19.12; P = .003).
At age 30 years, the RR for sudden cardiac death continued to be greater among those born small for gestational age compared with the reference group (RR = 1.65; 95% CI, 1.13-2.41; P = .01), but there was no longer a difference between those born large for gestational age and the reference group (RR = 1.6; 95% CI, 0.65-3.91; P = .305).
“The absolute risk of death of other causes was highest among infants with birth weight < 1,500 g,” the researchers wrote. “Although we attempted to reduce the possible influence of comorbidities and complications in relation to low birth weight and prematurity by estimating risks for those alive at 1 year of age, conditions associated with low birth weight may account for these findings.”
Risk for sudden arrhythmic death
Among the cases that were autopsied, the relative risk for sudden arrhythmic death syndrome at age 5 years for children who were small for gestational age was greater compared with the reference group (RR = 4.19; 95% CI, 1.08-16.22; P = .038), according to the study.
“On the basis of our findings, one may hypothesize that fetal arrhythmia or other conditions in the fetus caused by genetic mutations can impair fetal growth,” the researchers wrote. “However, these results may also indicate that conditions during pregnancy can impair the development of the heart with formation of electrical abnormalities. Thus, our results call for further investigation because it may add to the identification of people at risk of sudden arrhythmic death syndrome.”
Collapse
Click Here to Manage Email Alerts