University of Oulu

Johnson, L. S. B., Salonen, M., Kajantie, E., Conen, D., Healey, J. S., Osmond, C., & Eriksson, J. G. (2017). Early Life Risk Factors for Incident Atrial Fibrillation in the Helsinki Birth Cohort Study. Journal of the American Heart Association, 6(6).

Early life risk factors for incident atrial fibrillation in the Helsinki birth cohort study

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Author: Johnson, Linda S. B.1; Salonen, Minna2,3; Kajantie, Eero3,4,5;
Organizations: 1Department of Clinical Sciences, Lund University, Skåne University Hospital, Malmö, Sweden
2Folkhälsan Research Center, Helsinki, Finland
3Department of Chronic Disease Prevention, National Institute of Health and Welfare, Helsinki, Finland
4Children's Hospital, Helsinki University Hospital, University of Helsinki, Finland
5PEDEGO Research Unit, MRC Oulu, Oulu University Hospital and University of Oulu, Finland
6Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada
7Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, United Kingdom
8Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.2 MB)
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Language: English
Published: John Wiley & Sons, 2017
Publish Date: 2017-11-06


Background: Early life risk factors are associated with cardiometabolic disease, but have not been fully studied in atrial fibrillation (AF). There are discordant results from existing studies of birth weight and AF, and the impact of maternal body size, gestational age, placental size, and birth length is unknown.

Methods and Results: The Helsinki Birth Cohort Study includes 13 345 people born as singletons in Helsinki in the years 1934–1944. Follow‐up was through national registries, and ended on December 31, 2013, with 907 incident cases. Cox regression analyses stratified on year of birth were constructed for perinatal variables and incident AF, adjusting for offspring sex, gestational age, and socioeconomic status at birth. There was a significant U‐shaped association between birth weight and AF (P for quadratic term=0.01). The lowest risk of AF was found among those with a birth weight of 3.4 kg (3.8 kg for women [85th percentile] and 3.0 kg for men [17th percentile]). High maternal body mass index (≥30 kg/m²) predicted offspring AF; hazard ratio 1.36 (95% CI 1.07–1.74, P=0.01) compared with normal body mass index (<25 kg/m²). Maternal height was associated with early‐onset AF (<65.3 years), hazard ratio 1.47 (95% CI 1.24–1.74, P<0.0001), but not with later onset AF. Results were independent of incident coronary artery disease, hypertension, or diabetes mellitus.

Conclusions: High maternal body mass index during pregnancy and maternal height are previously undescribed predictors of offspring AF. Efforts to prevent maternal obesity might reduce later AF in offspring. Birth weight has a U‐shaped relation to incident AF independent of other perinatal variables.

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Series: Journal of the American Heart Association
ISSN: 2047-9980
ISSN-E: 2047-9980
ISSN-L: 2047-9980
Volume: 6
Issue: 6
Article number: e006036
DOI: 10.1161/JAHA.117.006036
Type of Publication: A1 Journal article – refereed
Field of Science: 3121 General medicine, internal medicine and other clinical medicine
Funding: Dr Johnson is supported by governmental funding within the Swedish National Health Services. The Helsinki Birth Cohort Study was supported by Signe and Ane Gyllenberg Foundation, Samfunder Folkhälsan, Finska Läkaresällskapet, Liv och Hälsa, and the Finnish Foundation for Cardiovascular Research. The Academy of Finland supported Dr Eriksson (grant no. 129369, 129907, 135072, 129255, and 126775). The research leading to these results has received funding from the European Commission within the 7th Framework Programme (DORIAN, grant agreement no. 278603) and EU H2020-PHC-2014-DynaHealth (grant no. 633595). Dr Healey is supported by McMaster University, and a Heart and Stroke Foundation of Ontario Mid-Career Award (MC7450). Dr Kajantie is supported by Academy of Finland grants (127437, 129306, 130326, 134791, 263924, 274794) as well as the Sigrid Juselius Foundation, the Finnish Foundation for Pediatric Research, the Finnish Foundation for Cardiovascular Research, the Novo Nordisk Foundation, and the Juho Vainio Foundation.
Copyright information: © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes