Maternal Education Before Childbirth and Cardiovascular Diseases in Offspring During Early Adulthood: A Danish Population-Based Cohort Study

• Published in: Canadian journal of cardiology 2021-12, Vol.37 (12), p.1951-1958
• Main Authors: Huang, Chen, Yu, Yongfu, Sørensen, Henrik Toft, Liu, Buyun, Vested, Anne, Cnattingius, Sven, Qin, Guoyou, Li, Jiong
• Format: Article
• Language: English
• Subjects: Adult; Cardiovascular Diseases - epidemiology; Delivery, Obstetric; Denmark - epidemiology; Educational Status; Female; Follow-Up Studies; Forecasting; Humans; Incidence; Infant, Newborn; Male; Population Surveillance - methods; Pregnancy; Pregnancy Complications, Cardiovascular - epidemiology; Retrospective Studies; Risk Factors; Young Adult
• ISSN: 0828-282X; 1916-7075
• DOI: 10.1016/j.cjca.2021.07.005

Cardiovascular disease (CVD) is increasing in youths, but there is limited knowledge about the etiology of early-onset CVD. We aimed to examine the association between maternal education before childbirth and CVD risk in offspring during early adulthood (20 to 40 years of age). This population-based cohort study included 112,3600 subjects born in Denmark during 1977 to 1996. Compared with offspring born to mothers with high education, offspring born to mothers with low or medium education had 27% (hazard ratio, 1.27; 95% confidence interval, 1.23-1.30) or 12% (1.12; 1.09-1.15) increased overall risk of early-onset CVD, respectively. Increased risks were observed for most type-specific CVDs: in particular, for myocardial infarction (low [2.03; 1.55-2.65] or medium education [1.52; 1.16-1.99]), heart failure (low [1.59; 1.24-2.03] or medium education [1.51; 1.19-1.92]), and ischemic stroke (low [1.50; 1.28-1.76] or medium education [1.29; 1.10-1.51]). We observed high incidences of CVD in offspring of mothers with comorbid CVD (low [1.67; 1.51-1.86] or medium education [1.46; 1.29-1.64]), compared with those of mothers with high education and no history of CVD. Low maternal education before childbirth, especially with maternal comorbid CVD, is significantly associated with increased risk of overall CVD and most type-specific CVDs in offspring in early adulthood. The influence of maternal education on future offspring CVD should be taken into consideration in the assessment of CVD risks from early decades of life. Les maladies cardiovasculaires (MCV) sont en augmentation chez les jeunes, mais les connaissances sur l'étiologie des MCV à apparition précoce sont limitées. Nous avons voulu examiner l'association entre le niveau d'éducation de la mère avant l'accouchement et le risque de MCV chez ses descendants au début de l'âge adulte (20 à 40 ans). Cette étude de cohorte basée sur la population comprenait 112 360 sujets nés au Danemark entre 1977 et 1996. Par rapport aux enfants nés de mères ayant un niveau d'éducation élevé, les enfants nés de mères ayant un niveau d'éducation faible ou moyen présentaient respectivement un risque global de MCV à apparition précoce accru de 27 % (rapport de risque, 1,27; intervalle de confiance à 95 %, 1,23-1,30) ou de 12 % (1,12; 1,09-1,15). Des risques accrus ont été observés pour la plupart des MCV caractérisées: en particulier, pour l'infarctus du myocarde (niveau d'éducation faible [2,03; 1,55-2,65] ou moyen [1,52; 1,16-1,