Birth measurements, family history, and environmental factors associated with later-life hypertensive status.

BACKGROUND: This birth cohort study was conducted to investigate the contribution of prenatal and antenatal environmental exposures to later-life hypertensive status. METHODS: Two thousand five hundred and three individuals born in 1921-1954 at the Peking Union Medical College Hospital (PUMCH) were targeted; 2,081 (83.1%) participated. Clinical examinations included an interview, blood pressure (BP) measurements, and laboratory assays. Statistical analyses were performed using ordinal regression models with later-life hypertensive status as the dependent variable. Similar analyses were for subpopulations divided by family history of hypertension. RESULTS: In the 2,081 subjects, 449 were normotensive, 531 were prehypertensive, and 1,101 had hypertension. Three hundred and forty two hypertensive patients were classified as high-risk (BP ≥180/110 mm Hg, or accompanied with diabetes or three well-established cardiovascular risk factors); the other 759 patients were at mid-to-low risks. Lower birth weight (<2,500 g: odds ratio (OR) = 1.67, P = 0.02; 2,500- <3,000 g: OR = 1.64, P < 0.01; 3,000- <3,500 g, OR = 1.40, P = 0.01), family history of hypertension (OR = 1.73, P < 0.01), poor education (OR = 1.76, P < 0.01), and alcoholism (OR = 3.05, P < 0.01) significantly predicted later-life high-risk hypertension. For participants with hypertensive family history (57.7%), the association with birth weight became nonsignificant, but poor education (OR = 2.33, P < 0.01) and alcoholism (OR = 3.10, P = 0.01) remained important. For participants without hypertensive family history (42.3%), the effects of lower birth weight (<2,500 g: OR = 2.26, P = 0.02; 2,500- <3,000 g: OR = 1.91, P = 0.01; 3,000- <3,500 g, OR = 1.78, P = 0.01) and alcoholism (OR = 3.23, P < 0.01) remained significant. CONCLUSION: Low birth weight, low education, alcoholism, and hypertensive family history are linked to later-life hypertensive status. Low birth weight is also partly associated with one's genetic background; whereas the association with education and alcoholism are independent from hypertensive family history.

Relationship between birth head circumference and adulthood quality of life in Chinese people.

AIM: To determine the relationship between birth size and later QOL for Chinese people. METHODS: Birth data of 1074 subjects were obtained from obstetric birth records of Peking Union Medical College Hospital. All subjects are interviewed face to face with the 36-Item Short-Form Health Survey scale by trained investigators. Linear regression model was used to analyse the relationship between QOL and birth head circumference of the subjects after adjusting for the childhood and adulthood characteristics. The relationship was described with regression coefficients (B) and its 95% confidence interval (CI). RESULTS: The mean weighted score of QOL was 88.1 ± 9.1, ranging from 76.8 to 100. Larger birth head circumference meant higher adulthood QOL total score (P= 0.001). After controlling the adulthood confounders, as compared to larger head circumference (≥33 cm), small (<31 cm) and medium head circumferences (31-33 cm) meant lower adulthood QOL scores (B=-2.356, P= 0.005 and B=-1.645, P= 0.014, respectively). The increase of head circumference by 1 cm was associated with 0.480 (95% CI: 0.141, 0.820) increase of QOL score after adjusting adulthood confounders (P= 0.006). CONCLUSIONS: This study validated the relationship between birth head circumference and QOL in later life. Smaller head circumference at birth could predict worse adulthood QOL at above 50 years old.

Relationship between perinatal characteristics and later activities of daily living in Chinese elderly people.

BACKGROUND: There are no reports on the association between perinatal characteristics and comprehensive physical function in Chinese elderly people. In this study, we traced 875 subjects who were born at the Peking Union Medical College Hospital (PUMCH) of China from 1921 to 1941. The purpose of this study was to determine the effects of perinatal characteristics on activities of daily living (ADL) function in the geriatric period. METHODS: Birth data of 875 subjects were obtained from obstetric birth records of PUMCH. Adulthood data collection was conducted in the outpatient clinics of PUMCH. During the clinic visits, trained research staff administered physical examinations, activities of daily living scale and a demographic questionnaire. ADLs of all subjects were assessed with the activities of daily living scale. RESULTS: There were 101 subjects whose ADL function was limited and the rate of ADL limitation was 11.5%. Binary logistic regression analyses results showed that the main influencing factors of ADL were age, maternal age at birth, occupation, daily exercise and chronic disease. Subjects whose maternal age at their birth exceeded 35 years were at 2.202 times (1.188 - 4.083) greater risk of ADL limitation when we applied multivariate logistic regression models. CONCLUSIONS: This study validated the relationship between perinatal characteristics and ADL in the geriatric period. An older maternal age at birth could predict a higher ADL limitation rate in the geriatric period.