scholarly journals Low Birth Weight Increases the Risk of Sudden Cardiac Death in the Young: A Nationwide Study of 2.2 Million People

2021 ◽  
Author(s):  
Vilde Waaler Loland ◽  
Frederik Nybye Ågesen ◽  
Thomas Hadberg Lynge ◽  
Anja Pinborg ◽  
Reza Jabbari ◽  
...  
Keyword(s):  
Birth Weight ◽  
Relative Risk ◽  
Sudden Cardiac Death ◽  
Gestational Age ◽  
Cardiac Death ◽  
Large For Gestational Age ◽  
Major Health Problem ◽  
Arrhythmic Death ◽  
Increased Risk ◽  
Sudden Arrhythmic Death Syndrome

Background Sudden cardiac death (SCD) constitutes a major health problem worldwide. We investigated whether birth weight (BW), small for gestational age (SGA), and large for gestational age are associated with altered risk of SCD among the young (aged 1–36 years). Methods and Results We included all people born in Denmark from 1973 to 2008 utilizing the Danish Medical Birth Register. All SCDs in Denmark in 2000 to 2009 have previously been identified. We defined 5 BW groups, SGA, and large for gestational age as exposure and SCD as the outcome. We estimated the age‐specific relative risk of SCD with 95% CI. Additionally, we investigated if SGA and large for gestational age are associated with pathological findings at autopsy. The study population for the BW analyses comprised 2 234 501 people with 389 SCD cases, and the SGA and large for gestational age analyses comprised 1 786 281 people with 193 SCD cases. The relative risk for SCD was 6.69 for people with BW between 1500 and 2499 g (95% CI, 2.38–18.80, P <0.001) and 5.89 for people with BW ≥4500 g (95% CI, 1.81–19.12, P =0.003) at age 5 years. BW 2500 to 3400 g was the reference group. Compared with an appropriate gestational age, the relative risk for SGA was 2.85 (95% CI, 1.35–6.00, P =0.006) at age 10 years. For the autopsied cases, the relative risk of sudden arrhythmic death syndrome at age 5 years was 4.19 for SGA (95% CI, 1.08–16.22, P =0.038). Conclusions We found an association between BW and SCD in the young, with an increased risk among SGA infants. In addition, we found an association between SGA and sudden arrhythmic death syndrome.

Abstract 15714: Prediction of Sudden Cardiac Death With Automated High-Throughput Analysis of T-Wave Heterogeneity in Standard 12-Lead Electrocardiogram

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Tuomas Kenttä ◽  
Bruce D Nearing ◽  
Kimmo Porthan ◽  
Jani T Tikkanen ◽  
Matti Viitasalo ◽  
...  
Keyword(s):  
At Risk ◽  
Relative Risk ◽  
Sudden Cardiac Death ◽  
General Population ◽  
Cardiac Death ◽  
Left Ventricular ◽  
Adjusted Relative Risk ◽  
T Wave ◽  
Increased Risk ◽  
Patients At Risk

Introduction: Noninvasive identification of patients at risk for sudden cardiac death (SCD) remains a major clinical challenge. Abnormal ventricular repolarization is associated with increased risk of lethal ventricular arrhythmias and SCD. Hypothesis: We investigated the hypothesis that spatial repolarization heterogeneity can identify patients at risk for SCD in general population. Methods: Spatial R-, J- and T-wave heterogeneities (RWH, JWH and TWH, respectively) were automatically analyzed with second central moment technique from standard digital 12-lead ECGs in 5618 adults (46% men; age 50.9±12.5 yrs.) who took part in Health 2000 Study, an epidemiological survey representative of the entire Finnish adult population. During average follow-up of 7.7±1.4 years, a total of 72 SCDs occurred. Thresholds of RWH, JWH and TWH were based on optimal cutoff points from ROC curves. Results: Increased RWH, JWH and TWH (Fig.1) in left precordial leads (V4-V6) were univariately associated with SCD (P<0.001, each). When adjusted with clinical risk markers (age, gender, BMI, systolic blood pressure, cholesterol, heart rate, left ventricular hypertrophy, QRS duration, arterial hypertension, diabetes, coronary heart disease and previous myocardial infarction) JWH and TWH remained as independent predictors of SCD. Increased TWH (≥102μV) was associated with a 1.9-fold adjusted relative risk (95% confidence interval [CI]: 1.2 - 3.1; P=0.011) and increased JWH (≥123μV) with a 2.0-fold adjusted relative risk for SCD (95% CI: 1.2 - 3.3; P=0.004). When both TWH and JWH were above threshold, the adjusted relative risk for SCD was 3.2-fold (95% CI: 1.7 - 6.2; P<0.001). When all heterogeneity measures (RWH, JWH and TWH) were above threshold, the risk for SCD was 3.7-fold (95% CI: 1.6 - 8.6; P=0.003). Conclusions: Automated measurement of spatial J- and T-wave heterogeneity enables analysis of high patient volumes and is able to stratify SCD risk in general population.

scholarly journals Sudden Cardiac Death in the Young

2020 ◽  
Vol 13 (10) ◽  
Author(s):  
Francis J. Ha ◽  
Hui-Chen Han ◽  
Prashanthan Sanders ◽  
Kim Fendel ◽  
Andrew W. Teh ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Artery Disease ◽  
Body Mass Index ◽  
Coronary Artery ◽  
Sudden Cardiac Death ◽  
Odds Ratio ◽  
Cardiac Death ◽  
Arrhythmic Death ◽  
Sudden Arrhythmic Death Syndrome ◽  
Artery Disease

Background: Sudden cardiac death (SCD) in the young is devastating. Contemporary incidence remains unclear with few recent nationwide studies and limited data addressing risk factors for causes. We aimed to determine incidence, trends, causes, and risk factors for SCD in the young. Methods and Results: The National Coronial Information System registry was reviewed for SCD in people aged 1 to 35 years from 2000 to 2016 in Australia. Subjects were identified by the International Classification of Diseases , Tenth Revision code relating to circulatory system diseases (I00–I99) from coronial reports. Baseline demographics, circumstances, and cause of SCD were obtained from coronial and police reports, alongside autopsy and toxicology analyses where available. During the study period, 2006 cases were identified (median age, 28±7 years; men, 75%; mean body mass index, 29±8 kg/m 2 ). Annual incidence ranged from 0.91 to 1.48 per 100 000 age-specific person-years, which was the lowest in 2013 to 2015 compared with previous 3-year intervals on Poisson regression model ( P =0.001). SCD incidence was higher in nonmetropolitan versus metropolitan areas (0.99 versus 0.53 per 100 000 person-years; P <0.001). The most common cause of SCD was coronary artery disease (40%), followed by sudden arrhythmic death syndrome (14%). Incidence of coronary artery disease–related SCD decreased from 2001–2003 to 2013–2015 ( P <0.001). Proportion of SCD related to sudden arrhythmic death syndrome increased during the study period ( P =0.02) although overall incidence was stable ( P =0.22). Residential remoteness was associated with coronary artery disease–related SCD (odds ratio, 1.44 [95% CI, 1.24–1.67]; P <0.001). For every 1-unit increase, body mass index was associated with increased likelihood of SCD from cardiomegaly (odds ratio, 1.08 [95% CI, 1.05–1.11]; P <0.001) and dilated cardiomyopathy (odds ratio, 1.04 [95% CI, 1.01–1.06]; P =0.005). Conclusions: Incidence of SCD in the young and specifically coronary artery disease–related SCD has declined in recent years. Proportion of SCD related to sudden arrhythmic death syndrome increased over the study period. Geographic remoteness and obesity are risk factors for specific causes of SCD in the young.

scholarly journals Large-for-gestational-age phenotypes and obesity risk in adulthood: a study of 195,936 women

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
José G. B. Derraik ◽  
Sarah E. Maessen ◽  
John D. Gibbins ◽  
Wayne S. Cutfield ◽  
Maria Lundgren ◽  
...  
Keyword(s):  
Birth Weight ◽  
Gestational Age ◽  
Reference Group ◽  
Ponderal Index ◽  
Large For Gestational Age ◽  
Adjusted Relative Risk ◽  
Obesity Risk ◽  
Increased Risk ◽  
Appropriate For Gestational Age ◽  
Using Data

AbstractWhile there is evidence that being born large-for-gestational-age (LGA) is associated with an increased risk of obesity later in life, the data are conflicting. Thus, we aimed to examine the associations between proportionality at birth and later obesity risk in adulthood. This was a retrospective study using data recorded in the Swedish Birth Register. Anthropometry in adulthood was assessed in 195,936 pregnant women at 10–12 weeks of gestation. All women were born at term (37–41 weeks of gestation). LGA was defined as birth weight and/or length ≥2.0 SDS. Women were separated into four groups: appropriate-for-gestational-age according to both weight and length (AGA – reference group; n = 183,662), LGA by weight only (n = 4,026), LGA by length only (n = 5,465), and LGA by both weight and length (n = 2,783). Women born LGA based on length, weight, or both had BMI 0.12, 1.16, and 1.08 kg/m2 greater than women born AGA, respectively. The adjusted relative risk (aRR) of obesity was 1.50 times higher for those born LGA by weight and 1.51 times for LGA by both weight and height. Length at birth was not associated with obesity risk. Similarly, women born LGA by ponderal index had BMI 1.0 kg/m2 greater and an aRR of obesity 1.39 times higher than those born AGA. Swedish women born LGA by weight or ponderal index had an increased risk of obesity in adulthood, irrespective of their birth length. Thus, increased risk of adult obesity seems to be identifiable from birth weight and ignoring proportionality.

scholarly journals Gestational Weight Gain Influences Neonatal Outcomes in Women With Obesity and Gestational Diabetes

2021 ◽  
Author(s):  
Ana M Ramos-Levi ◽  
Gemma Rodriguez-Carnero ◽  
Cristina Garcia-Fontao ◽  
Antia Fernandez-Pombo ◽  
Paula Andújar-Plata ◽  
...  
Keyword(s):  
Weight Gain ◽  
Birth Weight ◽  
Gestational Diabetes ◽  
Gestational Weight Gain ◽  
Gestational Age ◽  
Perinatal Outcomes ◽  
Large For Gestational Age ◽  
Gestational Weight ◽  
Increased Risk ◽  
The Impact

Abstract Background. Obesity and gestational diabetes mellitus (GDM) are associated to increased risk of perinatal complications and obesity in the offspring. However, the impact of gestational weight gain (GWG) on maternal and fetal outcomes has led to controversial results. Research design and methods. Retrospective study of 220 women with GDM and pre-pregnancy body mass index (BMI) ≥ 30 kg/m2. Pregnant women were classified according to the Institute of Medicine (IOM) recommendations regarding prior BMI and GWG. We evaluated the impact of GWG on birth weight and perinatal outcomes. Results. Mean maternal age was 34.7±5.3 years. Pre-pregnancy obesity was classified as grade I in 55.3% of cases, grade II in 32.0%, and grade III in 12.7%. GWG was adequate (5-9kg) in 24.2%, insufficient (< 5kg) in 41.8% and excessive (> 9kg) in 34.2%. Birthweight was within normal range in 81.9%, 3.6% were small for gestational age (SGA) and 14.4% were large for gestational age (LGA). Insufficient GWG was associated to a higher rate of SGA offspring, excessive GWG was associated to LGA and adequate GWG to normal birth weight. Conclusion. GWG in women with pre-pregnancy obesity and GDM impacts neonatal birthweight. Insufficient GWG is associated to SGA and excessive GWG is associated to LGA. Women with adequate GWG according to IOM guidelines obtained better perinatal outcomes.

Congenital Heart Disease in non-Diabetic Large-for-Gestational-Age (LGA) Neonates

2020 ◽  
Vol 20 ◽  
Author(s):  
Majid Firouzi ◽  
Hamidreza Sherkatolabbasieh ◽  
Alireza Nezami ◽  
Shiva Shafizadeh
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Birth Weight ◽  
Gestational Age ◽  
Congenital Heart ◽  
Heart Diseases ◽  
Large For Gestational Age ◽  
Congenital Heart Diseases ◽  
Increased Risk ◽  
Heart Abnormalities

Background: Congenital heart diseases are the most prevalent congenital abnormalities in the neonates, caused by the environmental and genetic factors and contribute to the leading cause of death. The aim of this study is to evaluate the relationship between neonates with large for gestational age and increased risk of congenital heart diseases among nondiabetic mothers. Methods: In this study, 179 neonates with large for gestational age in Khorramabad were enrolled where heart abnormalities were evaluated using echocardiography. Results: 87 neonates had more than 4000 g of the birth weight with no heart abnormalities and 92 (51%) macrosomic neonates had congenital heart diseases. Statistical analysis revealed that there was a significant relationship between birth weight and increased risk of acquiring congenital heart disease between the two groups. There was no significant relationship between birth weight, maternal age, gender, labor type and blood group between the two groups. The highest incidence of congenital heart anomalies was related to 38% of arterial septal defect (ASD) and 15.2% of ASD and VSD, respectively Conclusion: The most prevalent abnormality was arterial septal ASD. None of these abnormalities were associated with maternal age, birth weight and neonate gender. Future studies for congenital heart disease and neonatal birth weight are therefore, recommended.

Postmortem genetic testing in sudden death cases

ESC CardioMed ◽  
2018 ◽  
pp. 685-688
Author(s):  
Najim Lahrouchi ◽  
Elijah R. Behr ◽  
Connie R. Bezzina
Keyword(s):  
Genetic Testing ◽  
Sudden Cardiac Death ◽  
Cardiac Disease ◽  
Cardiac Death ◽  
Arrhythmic Death ◽  
Sudden Unexplained Death ◽  
Unexplained Death ◽  
Sudden Arrhythmic Death Syndrome ◽  
Death Cases ◽  
Postmortem Genetic Testing

Postmortem analysis of young sudden cardiac death patients leads to a diagnosis of structural cardiac disease in the majority of cases. However, despite thorough autopsy, including toxicological and histological analysis, in one-third of patients no cause of death is identified and these patients are classified as sudden unexplained death or sudden arrhythmic death syndrome. Postmortem genetic testing in these patients can establish a genetic aetiology of sudden cardiac death, which allows for appropriate screening and management of family members at risk of sudden cardiac death.

scholarly journals Genetic Risk Score for Prediction of Newborn Adiposity and Large-for-Gestational-Age Birth

2014 ◽  
Vol 99 (11) ◽  
pp. E2377-E2386 ◽  
Author(s):  
Reeti Chawla ◽  
Sylvia E. Badon ◽  
Janani Rangarajan ◽  
Anna C. Reisetter ◽  
Loren L. Armstrong ◽  
...  
Keyword(s):  
Birth Weight ◽  
Risk Score ◽  
Gestational Age ◽  
Genetic Risk ◽  
Genetic Risk Score ◽  
Large For Gestational Age ◽  
Adult Obesity ◽  
Maternal Genotype ◽  
Increased Risk ◽  
Newborn Size

Context: Macrosomic infants are at increased risk for adverse metabolic outcomes. Improving prediction of large-for-gestational-age (LGA) birth may help prevent these outcomes. Objective: This study sought to determine whether genes associated with obesity-related traits in adults are associated with newborn size, and whether a genetic risk score (GRS) predicts LGA birth. Setting and Design: Single nucleotide polymorphisms (SNPs) in 40 regions associated with adult obesity-related traits were tested for association with newborn size. GRS's for birth weight and sum of skinfolds (SSF) specific to ancestry were calculated using the most highly associated SNP for each ancestry in genomic regions with one or more SNPs associated with birth weight and/or SSF in at least one ancestry group or meta-analyses. Participants: Newborns from the Hyperglycemia Adverse Pregnancy Outcomes Study were studied (942 Afro-Caribbean, 1294 Northern European, 573 Mexican-American, and 1182 Thai). Outcome Measures: Birth weight &gt;90th percentile (LGA) and newborn SSF &gt;90th percentile were primary outcomes. Results: After adjustment for ancestry, sex, gestational age at delivery, parity, maternal genotype, maternal smoking/alcohol intake, age, body mass index, height, blood pressure and glucose, 25 and 23 SNPs were associated (P &lt; .001) with birth weight and newborn SSF, respectively. The GRS was highly associated with both phenotypes as continuous variables across all ancestries (P ≤ 1.6 × 10−19) and improved prediction of birth weight and SSF &gt;90th percentile when added to a baseline model incorporating the covariates listed above. Conclusions: A GRS comprised of SNPs associated with adult obesity-related traits may provide an approach for predicting LGA birth and newborn adiposity beyond established risk factors.

Nutrition in pregnancy

2020 ◽  
pp. 2568-2574
Author(s):  
David J. Williams
Keyword(s):  
Birth Weight ◽  
Gestational Age ◽  
Later Life ◽  
Large For Gestational Age ◽  
Normal Body Mass Index ◽  
Nutritional Advice ◽  
Increased Risk ◽  
The World ◽  
Negative Effect ◽  
Access To Food

Nutritional requirements for healthy pregnancy vary according to a woman’s pre-pregnancy nutritional state and her access to food during pregnancy: there is no unifying nutritional advice that is appropriate for all pregnant women throughout the world, or even within nations. Around the world, obesity and excessive gestational weight gain are now more common risk factors for pregnancy complications than undernutrition. Compared with mothers who have a normal body mass index or BMI (18.5–24.9 kg/m2), obese mothers have an increased risk of gestational diabetes, pre-eclampsia, caesarean delivery, stillbirth, congenital malformations, and large for gestational age babies. Underweight mothers have an increased risk of small for gestational age babies, and preterm birth. Paternal obesity has a negative effect on fetal growth, probably mediated by inheritance of insulin resistance. Both low birth weight and high birth weight babies have an increased risk of obesity in later life.

IGF-II expression and methylation in small for gestational age infants

2015 ◽  
Vol 28 (5-6) ◽  
Author(s):  
Shulian Zhang ◽  
Guanpeng Zhai ◽  
Jin Wang ◽  
Wenjing Shi ◽  
Rong Zhang ◽  
...  
Keyword(s):  
Birth Weight ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Newborn Infants ◽  
Adult Life ◽  
Adverse Outcomes ◽  
Large For Gestational Age ◽  
Increased Risk ◽  
The Status ◽  
Appropriate For Gestational Age

AbstractLow birth weight is associated with an increased risk of adverse outcomes in many diseases in adult life. We investigated the expression of IGF-II and the status of differentially methylated regions (DMR) in small for gestational age (SGA) infants after birth.Plasma IGF-II, IGF-II receptor (IGF2R), IGF-I, and IGF-binding protein 3 (IGFBP3) levels were measured after birth in 150 newborn infants. These included 30 term appropriate for gestational age (AGA), 30 term SGA, 30 term large for gestational age (LGA), 30 preterm AGA, and 30 preterm SGA infants.Plasma IGF-II levels after birth were lower in both term SGA (435.1±33.82 vs. 620.4±44.79, p=0.002) and LGA infants (483.7±33.8 vs. 620.42±44.79, p=0.018) than in term AGA infants. The expression ofIGF-II was associated with birth weight and expressed at high levels, which suggests that IGF-II may continue to play an important role after birth.

scholarly journals Effect of maternal weight gain according to the Institute of Medicine recommendations on pregnancy outcomes in a Chinese population

2019 ◽  
Vol 47 (9) ◽  
pp. 4397-4412 ◽  
Author(s):  
Ping Guan ◽  
Fei Tang ◽  
Guoqiang Sun ◽  
Wei Ren
Keyword(s):  
Weight Gain ◽  
Birth Weight ◽  
Preterm Birth ◽  
Low Birth Weight ◽  
Gestational Age ◽  
Pregnancy Outcomes ◽  
Adverse Outcomes ◽  
Large For Gestational Age ◽  
Maternal Weight ◽  
Increased Risk

Objective This study aimed to analyze the effects of maternal weight on adverse pregnancy outcomes. Methods Data were retrospectively collected from a hospital in Wuhan, China. A total of 1593 pregnant women with singletons were included. Adverse outcomes during pregnancy, such as small for gestational age (SGA), large for gestational age (LGA), and hypertensive disorders in pregnancy (HDP) were analyzed. Results The risks of low birth weight, SGA, and preterm birth were significantly higher in the inadequate gestational weight gain (GWG) group compared with the adequate GWG group. GWG over the guidelines was related to a higher risk of macrosomia, LGA, cesarean section, and HDP than GWG within the guidelines. The risks of low birth weight (OR = 5.082), SGA (OR = 3.959), preterm birth (OR = 3.422), and gestational diabetes mellitus (OR = 1.784) were significantly higher in women with a normal pre-pregnancy body mass index (BMI) and inadequate GWG compared with women with a normal pre-pregnancy BMI and adequate GWG. The risks of macrosomia (OR = 3.654) and HDP (OR = 1.992) were increased in women with normal pre-pregnancy BMI and excessive GWG. Conclusion Women with an abnormal BMI and inappropriate GWG have an increased risk of adverse maternal and infant outcomes. Weight management during the perinatal period is required.

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