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Cerebrovascular and ischemic heart disease in young adults born preterm: a population-based Swedish cohort study

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Abstract

Preterm birth is associated with overall cardiovascular mortality in young adulthood, but which specific conditions that underlie this association is unknown. We studied mortality and morbidity from cerebrovascular and ischemic heart disease in individuals born preterm. In a nationwide Swedish study, we included 1,306,943 individuals without congenital malformations born between 1983 and 1995, followed from 15 years of age to December 31st, 2010. Of these, 73,489 (5.6 %) were born preterm (<37 weeks of gestation). Cox proportional hazards regression analysis was used to calculate hazard ratios (HR) with 95 % confidence intervals (CI), after adjusting for maternal characteristics and birth weight for gestational age. Of 955 incident cases of cerebrovascular disease, 58 (6.1 %) occurred in preterm born subjects. The corresponding numbers of ischemic heart disease cases were 180 and 13 (7.2 %), respectively. Birth before 32 weeks was associated with a nearly twofold increased risk of cerebrovascular disease; adjusted HR, (95 % CI) = 1.89 (1.01–3.54) compared to term born individuals, whereas individuals born at 32–36 weeks were not at increased risk. Preterm birth was not associated with later ischemic heart disease; no cases of ischemic heart disease were recorded among those born before 32 weeks and the HR (95 % CI) for those born at 32–36 weeks of gestation was 1.45 (0.81–2.57), compared to term-born individuals. Birth before 32 weeks is associated with increased risk of cerebrovascular disease in young adulthood. Our data suggest that cardiovascular health promotion in follow-up programs after very preterm birth may be beneficial.

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Acknowledgments

The study was funded by the MD-PhD program Karolinska Institutet (PU), Swedish Society for Medical Research, Swedish Council for Working Life and Social Research (Grant No. 2010-0643) (AKB), the European Union’s Seventh Framework Programme (FP7/2007-2011) under Grant Agreement 259679 (SC), and the regional agreement on medical training and clinical research (ALF) between Stockholm County Council and Karolinska Institutet (OS).

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Authors and Affiliations

  1. Clinical Epidemiology Unit, Department of Medicine, Solna, Karolinska Institutet, T2, Karolinska University Hospital Solna, 171 76, Stockholm, Sweden

    Peter Ueda, Sven Cnattingius, Olof Stephansson & Anna-Karin Edstedt Bonamy

  2. Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden

    Olof Stephansson & Anna-Karin Edstedt Bonamy

  3. Department of Medical Sciences, Molecular Epidemiology and Science for Life Laboratory, Uppsala University, Uppsala, Sweden

    Erik Ingelsson

  4. Department of Pediatrics, Örebro University Hospital, Örebro, Sweden

    Jonas F. Ludvigsson

  5. Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden

    Jonas F. Ludvigsson

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  1. Peter Ueda
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Correspondence to Anna-Karin Edstedt Bonamy.

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Ueda, P., Cnattingius, S., Stephansson, O. et al. Cerebrovascular and ischemic heart disease in young adults born preterm: a population-based Swedish cohort study. Eur J Epidemiol 29, 253–260 (2014). https://doi.org/10.1007/s10654-014-9892-5

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  • DOI: https://doi.org/10.1007/s10654-014-9892-5

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