Prenatal growth and risk of occlusive and haemorrhagic stroke in Swedish men and women born 1915-29: historical cohort study. (Papers).

Evidence for an inverse association of impaired fetal growth with stroke is less securely established than that with coronary heart disease. Even less is known about the association of fetal growth with occlusive stroke and haemorrhagic stroke.

Participants, methods, and results

The cohort comprises all 14 611 births in the Uppsala Academic Hospital between 1915 and 1929. (1) Socioeconomic circumstances and neonatal characteristics, including gestational age (number of completed weeks since last menstrual period), were available for 96% of the subjects from hospital records and follow up is 98% complete. Analyses were restricted to singletons born at 30-45 weeks' gestation for whom information was available in the 1960 and 1970 censuses. Data on occurrence of first stroke were obtained from the Swedish national hospital discharge register (2) and from the national cause of death register. Two subtypes of stroke were defined--haemorrhagic (ICD-8 (international classification of diseases, 8th revision) 430-431; ICD-9 430-432) and occlusive (ICD-8 432-436; ICD-9 433-436). Each participant was considered at risk from the time of the 1970 census to date of first stroke, emigration, death, or end of follow up (31 December 1996).

The 10853 men and women had 991 first strokes--156 haemorrhagic, 775 occlusive, and 60 ill defined. Death certificates identified 41 (26%) first haemorrhagic strokes and 17 (2%) occlusive strokes. Of haemorrhagic strokes, 21 (13%) were subarachnoid and 135 (87%) intracerebral or unspecified intracranial haemorrhages.

Cox proportional hazards model showed birth weight inversely associated with risk…