University of Oulu

Kivelä, M., Rissanen, I., Kajantie, E., Ijäs, H., Rusanen, H., Miettunen, J., & Paananen, M. (2021). Pregnancy Risk Factors as Predictors of Offspring Cerebrovascular Disease. Stroke 52(4), 1347–1354.

Pregnancy risk factors as predictors of offspring cerebrovascular disease : the Northern Finland Birth Cohort Study 1966

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Author: Kivelä, Milja1,2; Rissanen, Ina2,3,4; Kajantie, Eero5,6,7;
Organizations: 1Center for Life Course Health Research, University of Oulu, Finland
2Medical Research Center Oulu, Oulu University Hospital, University of Oulu, Finland
3Research Unit of Clinical Neuroscience, Oulu University Hospital, University of Oulu, Finland
4Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, the Netherlands
5PEDEGO Research Unit, MRC Oulu, Oulu University Hospital, University of Oulu, Finland
6Finnish Institute for Health and Welfare, Public Health Promotion Unit, Helsinki and Oulu, Finland
7Norwegian University of Science and Technology, Department of Clinical and Molecular Medicine, Trondheim, Norway
8Department of Neurology, Oulu University Hospital
9Kerava Health Care Center, Finland
Format: article
Version: accepted version
Access: open
Online Access: PDF Full Text (PDF, 0.3 MB)
Persistent link:
Language: English
Published: Wolters Kluwer, 2021
Publish Date: 2022-01-03


Background and Purpose: For prevention of cerebrovascular diseases, it is important to understand the risk factors occurring early in life. The aim was to investigate the relationship of maternal and offspring anthropometrics and pregnancy complications with offspring’s risk of ischemic and hemorrhagic stroke and transient ischemic attack in adulthood.

Methods: Within the population-based prospective Northern Finland Birth Cohort 1966, 11 991 persons were followed from early pregnancy to 52 years of age. Information on pregnancy and birth complications were collected starting between 24th and 28th gestational week and at birth. Ischemic and hemorrhagic strokes of the offspring were identified from national registers in Finland. Cox proportional hazard models were used to estimate the association of pregnancy and birth complications with incidence of cerebrovascular disease in the offspring, with adjustments for sex, family socioeconomic status, mother’s age, and smoking during pregnancy.

Results: During 568 821 person-years of follow-up, 453 (3.8%) of the offspring had a stroke or transient ischemic attack. Small and large gestational weight gain among normal weight mothers were associated with increased ischemic stroke risk in offspring (adjusted hazard ratio [aHR], 1.93 [95% CI, 1.28–2.90] and aHR, 1.54 [95% CI, 1.02–2.31], respectively). Small birth weight for gestational age and small ponderal index were associated with increased risk for ischemic stroke (aHR, 1.95 [CI, 1.21–3.13] and aHR, 1.36 [CI, 1.04–1.77], respectively). Threatening miscarriage was also associated with increased risk of any stroke (aHR, 1.64 [CI 1.14–2.37]). Maternal smoking, hypertension, or birth complications were not associated with increased risk of cerebrovascular disease in the offspring.

Conclusions: The results of this study suggest that disturbances in maternal and fetal growth during pregnancy may predispose offspring to developing cerebrovascular diseases in adulthood.

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Series: Stroke
ISSN: 0039-2499
ISSN-E: 1524-4628
ISSN-L: 0039-2499
Volume: 52
Issue: 4
Pages: 1347 - 1354
DOI: 10.1161/STROKEAHA.120.031618
Type of Publication: A1 Journal article – refereed
Field of Science: 3123 Gynaecology and paediatrics
3124 Neurology and psychiatry
3142 Public health care science, environmental and occupational health
Funding: We thank NFBC1966; University of Oulu (65354, 24000692); Oulu University Hospital (2/97, 8/97, 24301140); Ministry of Health and Social Affairs (23/251/97, 160/97, 190/97); National Institute for Health and Welfare (54121); Oulu Regional Institute of Occupational Health (50621, 54231); and ERDF European Regional Development Fund (539/2010 A31592).
Copyright information: © 2021 American Heart Association, Inc. The final authenticated version is available online at