Literature review for - Flourish Paediatrics

Table 1 Death rates from coronary artery disease among 16 000 men and women born in
Hertfordshire between 1911 and 1920, by birthweight
Birthweight (pounds)
Standardised
mortality ratio
Deaths
(number)
9.5 65 57
All 74 941
A more recent systematic review of similar studies has found a 25% decrease in diabetes risk for every
one kg increase in weight at birthweight (Whincup, Kaye et al. 2008). However, this relationship only
holds for what is regarded as the normal range of birthweights (2500- 4000 or 4500grams) with the
association between birthweight and diabetes becoming positive at high birthweights (Yajnik 2010).
The risk of macrosomia and metabolic syndrome has been well recognised.
Barker’s original studies were criticized on the basis of confounding by social class or biased results
from the relatively low follow-up rate may have resulted in biased results. Since that time, however, the
results of other published studies have overcome these objections, with a large number of studies across
different cultures with different endpoints strengthening the hypothesis. Most notable are the studies
from Scandinavia, particularly Helsinki, where a comprehensive database and excellent follow-up have
allowed for more detailed work (Forsén, Eriksson et al. 1999; Forsen, Eriksson et al. 2000; Barker,
Osmond et al. 2009). The Finnish studies added to knowledge of how growth during infancy and
childhood modifies health outcomes. The path of growth during childhood modifies the risk of disease
associated with small body size at birth. The highest death rates from coronary heart disease were found
in men who were thin at birth but who had accelerated growth rates during the first year of life, resulting
in above average body mass at one year. Other confirmatory studies for the hypothesis have come from
continuing analysis of the results of the famine in Holland during World War II (Roseboom, Van der
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