Birth Weight in Consecutive Pregnancies and Maternal Cardiovascular Disease Mortality Among Spontaneous and Iatrogenic Term Births: A Population-Based Cohort Study

Abstract Knowledge on the association between offspring birth weight and long-term risk of maternal cardiovascular disease (CVD) mortality is often based on firstborn infants without consideration of women’s consecutive births. We studied long-term CVD mortality according to offspring birth weight p...

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Bibliographic Details
Published in:American journal of epidemiology 2023-08, Vol.192 (8), p.1326-1334
Main Authors: Sima, Yeneabeba Tilahun, Skjaerven, Rolv, Kvalvik, Liv Grimstvedt, Morken, Nils-Halvdan, Klungsøyr, Kari, Mannseth, Janne, Sørbye, Linn Marie
Format: Article
Language:English
Subjects:
Birth Weight
Births
Cardiovascular disease
Cardiovascular Diseases
Cohort analysis
Cohort Studies
Confidence intervals
Female
Gestational age
Health risks
Heart diseases
Heterogeneity
Humans
Iatrogenesis
Iatrogenic Disease - epidemiology
Infant
Infants
Mortality
Mortality risk
Offspring
Original Contribution
Parturition
Population studies
Pregnancy
Quartiles
Risk
Statistical analysis
Term Birth
Weight
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Summary:Abstract Knowledge on the association between offspring birth weight and long-term risk of maternal cardiovascular disease (CVD) mortality is often based on firstborn infants without consideration of women’s consecutive births. We studied long-term CVD mortality according to offspring birth weight patterns among women with spontaneous and iatrogenic term deliveries in Norway (1967–2020). We constructed birth weight quartiles (Qs) by combining standardized birth weight with gestational age in quartiles (Q1, Q2/Q3, and Q4) for the women’s first 2 births. Mortality was estimated using Cox regression and expressed as hazard ratios (HRs) with 95% confidence intervals (CIs). Changes in offspring birth weight quartiles were associated with long-term maternal CVD mortality. Compared with women who had 2 term infants in Q2/Q3, women with a first offspring in Q2/Q3 and a second in Q1 had higher mortality risk (HR = 1.33, 95% CI: 1.18, 1.50), while risk was lower if the second offspring was in Q4 (HR = 0.78, 95% CI: 0.67, 0.91). The risk increase associated with having a first infant in Q1 was eliminated if the second offspring was in Q4 (HR = 0.99, 95% CI: 0.75, 1.31). These patterns were similar for women with iatrogenic and spontaneous deliveries. Inclusion of information from subsequent births revealed heterogeneity in maternal CVD mortality which was not captured when using only information based on the first offspring.
ISSN:0002-9262
1476-6256
DOI:10.1093/aje/kwad075