Preterm, Large or Small for gestational age babies may have Increased AF Risk: JAMA

Sweden: A new multinational cohort study published in JAMA: Pediatrics has revealed that adverse birth outcomes, including preterm birth and large or small for gestational age (LGA or SGA), are associated with increased risks of atrial fibrillation (AF) later in life.

AF is a type of irregular heartbeat that can lead to serious health complications, including stroke, heart failure, and even death. Medical birth registers recognize preterm birth (less than 37 gestational weeks), SGA (less than 10th percentile birth weight for gestational age), and LGA (greater than 90th percentile birth weight for gestational age).

The study included data from Denmark, Sweden, and Finland, analyzed live singleton births between 1973 and 2016, and followed up until 2021 in Sweden, 2016 in Denmark, and 2014 in Finland. The study involved 8,012,433 participants, with a median age of 21 years and a maximum age of 49 years.

The study revealed the following key takeaways:

1. During the 174.4 million person-years of follow-up, 11,464 participants were diagnosed with AF, which is equivalent to 0.14% of the cohort.

2. Both preterm birth and LGA were associated with an increased risk of AF in the full population cohort and in the sibling analyses.

3. Preterm birth was found to be more strongly associated with AF in childhood than in adulthood.

4. Children born SGA had an increased risk of AF in the first 18 years of life but not thereafter.

The results suggest that preterm and LGA births are associated with an increased risk of AF up to middle age, independently of familial confounding factors, while individuals born SGA had an increased AF risk only during childhood.

The researchers of the study conclude that “Adverse birth outcomes are linked to an increased risk of developing AF, which highlights the importance of understanding the relationship between birth outcomes and adult health. Further research is needed to determine the underlying mechanisms behind this association and develop appropriate interventions to prevent AF.”

Reference:

Yang F, Janszky I, Gissler M, et al. Preterm Birth, Small for Gestational Age, and Large for Gestational Age and the Risk of Atrial Fibrillation Up to Middle Age. JAMA Pediatr. Published online April 24, 2023. doi:10.1001/jamapediatrics.2023.0083