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Cited by 381Birth, Development, and HealthPregnancy and preeclampsia studiesPrenatal Substance Exposure Effects

Mothers' pelvic size, fetal growth, and death from stroke and coronary heart disease in men in the UK

Martyn, CN, Barker, DJP, Osmond, C·1996·The Lancet
DOI 10.1016/s0140-6736(96)04257-2
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Abstract

Background People who have a low birthweight show increased death rates from coronary heart disease and a higher prevalence for its risk factors. These findings have led to the hypothesis that the disease is programmed in fetal life. The aim of this study was to explore whether risk of stroke in adult life was linked to impaired fetal growth.Methods We ascertained deaths from stroke and coronary heart disease in 13 249 men in two cohorts from Hertfordshire and Sheffield, UK. We related death rates from these disease to body size at birth, weight at 1 year, and to measurements of the mothers' pelvises.Findings Death rates from both stroke and coronary heart disease tended to be highest in men whose birthweight had been low. Standardised mortality ratios (SMRs) for stroke fell by 12% (95% Cl 1-22) and for coronary heart disease by 10% (6-14) between each of five groupings of increasing birthweight (< or = 5.5 lb, 5.6-6.5 lb, 6.6-7.5 lb, 7.6-8.5 lb, and > 8.5 lb). Mortality from stroke was most strongly associated with low birthweight in relation to head size, and low placental weight in relation to head size. These patterns of growth occurred in offspring of mothers with flat bony pelvises. The SMR in sons of these women was 184 (67-396) compared with 104 (78-138) in the remainder of the cohort. In contrast, mortality from coronary heart disease was associated with small head circumference, thinness or shortness at birth and an altered ratio of placental weight to birthweight.Interpretation Stroke may originate in poor nutrition during the mother's childhood, which deforms the bony pelvis and subsequently impairs her ability to sustain the growth of the placenta and fetus in late pregnancy. Coronary heart disease, on the other hand, seems to originate in adaptations made by the fetus to inadequate delivery of nutrients when it occurs for reasons other than failure of placental growth.

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  • The risk of cardiovascular disease in adult men in relation to the birth weight to placental weight ratio is U-shaped, with heart-related death rates lowest when placental weight is about 19% of birth weight.

    “The risk of cardiovascular disease in adult men in relation to the birth weight to placental weight ratio does not follow a linear fashion as one might expect, but rather a “U” shaped pattern with heart-related death rates being lowest when placental weight is ~19% of birth weight (Figure 5) (25, 217, 361).”

    From Placental Origins of Chronic Disease (2016) · cites this paper as [361]

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Authors
Martyn, C., Barker, D., & Osmond, C.
Affiliations
Southampton General Hospital (GB)
ORCID
Osmond, C
Venue
The Lancet
Publisher
Elsevier BV
Published
1996-11
Volume
348
Issue
9037
Pages
1264-1268
ISSN
  • 0099-5355 (ISSN-L)
  • 0140-6736
DOI
10.1016/s0140-6736(96)04257-2
OpenAlex
W2015470285
Cited by
381
References
21
Citations by year
2026: 1 · 2025: 4 · 2024: 5 · 2023: 4 · 2022: 5 · 2021: 8 · 2020: 6 · 2019: 10 · 2018: 11 · 2017: 13 · 2016: 9 · 2015: 15 · 2014: 15 · 2013: 19 · 2012: 18
FWCI
17.49
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • The Lancet (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Birth, Development, and Health
  • Health Sciences › Medicine › Obstetrics and Gynecology › Pregnancy and preeclampsia studies
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Prenatal Substance Exposure Effects
Keywords
low birth weight, fetal growth restriction, stroke mortality, coronary heart disease mortality, fetal programming, placental weight, head circumference, birth weight, child malnutrition
MeSH terms
Adult, Aged, Aged, 80 and over, Birth Weight, Cerebrovascular Disorders, Coronary Disease, England, Female, Embryonic and Fetal Development, Humans, Infant, Newborn, Male, Pelvis, Pregnancy, Risk Factors, Cohort Studies

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