Associations of Birth‐Related Factors With Adult Weight Status and Blood Pressure: Findings From the Longitudinal Framingham Offspring Cohort
Authors: Parekh Niyati , Lin Yong , Freudenheim Jo L. , Deierlein Andrea 
Published: November 2023

Objective

Birth and early life factors are hypothesized to influence the risk of obesity and other metabolic risk factors in adult life. The longitudinal Framingham Offspring Cohort (FOS) with a follow‐up of 4 decades provides a unique opportunity to investigate birth characteristics with health outcomes in adulthood. The objective of this study was to investigate whether birth weight and mode of delivery are associated with body mass index (BMI) and blood pressure in adulthood.

Methods

Existing data were used from 3,007 predominantly Caucasian men and women, 18 years and older, participating in the longitudinal Framingham Heart Study‐Offspring Cohort (FOS). Participants were recruited from Framingham, Massachusetts, in 1971–1975 (exam 1) and re‐interviewed with in‐person medical exams approximately every four years until 2008 (exam 8). Participants provided self‐reported birth weight (n=1,463) and mode of delivery (vaginal or Cesarean section) (n=2,832). BMI, systolic blood pressure (SBP), and diastolic blood pressure (DBP) were measured at medical exams up to 8 times throughout adulthood (exams 1–8). Sex‐ and age‐adjusted linear mixed effect models accounting for repeated measurements, were used to assess the associations of birth factors with BMI and blood pressure within the entire population, and stratified by sex. All analyses were done using SAS v9.4.

Results

There were 1,419 (47.2%) men at exam 1 and 1,157 (45.6%) at exam 8, and 1588 (52.8%) women at exam 1 and 1,381 (54.4%) at exam 8. The mean age of participants was 35.2 and 67.1 years at exams 1 and 8, respectively. About 5% of participants were born via Cesarean delivery (n=144). Nearly half (n=1446, 46.7%) of participants were overweight/obese (BMI ≥ 25) at exam 1 and 72.1% (n=1,776) were overweight/obese at Exam 8. Mean SBP was 120.1 and 129.6 mmHg and mean DBP was 77.7 and 73.6 mmHg at exams 1 and 8, respectively. Cesarean delivery was positively associated with DBP (p<0.001), but not BMI (p=0.613) or SBP (p=0.198) in the entire population. In sex stratified analyses, associations with DBP remained statistically significant for both men and women (p≤0.018). Birth weight was positively associated with adult BMI (p=0.046), SBP (p=0.011), and DBP (p=0.052). In sex‐stratified analyses, associations persisted for birth weight and BMI among men (p=0.052) but not women (p=0.185), while associations for birth weight with SBP and DBP were observed among women (p=0.048 and p=0.057, respectively) but not men (p=0.254 and p=0.712, respectively).

Conclusions

In this study, we observed that birth weight was associated with BMI and blood pressure in adult life and these associations may differ by sex. These preliminary findings are consistent with those from previous studies and suggest that the implementation of interventions during the prenatal period may have a lasting influence on the metabolic health of offspring.

Support or Funding Information

This research was supported by The American Cancer Society Research Scholar Grant (#RSG‐12‐005‐01‐CNE) awarded to Niyati Parekh.