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Length of gestation is associated with mortality from cerebrovascular disease
  1. Ilona Koupil1,
  2. David A Leon2,
  3. Hans O Lithell3
  1. 1Centre for Health Equity Studies, Stockholm University/Karolinska Institute, Stockholm, Sweden
  2. 2Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
  3. 3Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
  1. Correspondence to:
 Professor I Koupil
 Centre for Health Equity Studies, Stockholm University/Karolinska Institute, SE-106 91 Stockholm, Sweden;

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Recent studies reported on increased levels of adult cardiovascular risk factors in subjects born prematurely,1 and on interactions between length of gestation and size at birth in their effect on cortisol metabolism,2 and blood pressure.3 The effect of fetal growth rate and the length of gestation on circulatory disease are explored in this study.


In a cohort of 14 193 men and women born in Uppsala in 1915–1929, we studied the associations of fetal growth rate and length of gestation with the risk of death from ischaemic heart disease (ICD 7: 420–422; 8 and 9: 410–414; 10: I20–25) and cerebrovascular disease (ICD 7: 330–334; 8 and 9: 430–438, 10: I60–69). Occlusive strokes include ICD7: 332–334, ICD8: 432–436, ICD9: 433–436 and ICD10: I63–66. Data on deaths and emigrations were obtained by linkage to the population and death registers.

Socioeconomic circumstances at birth and neonatal characteristics, including gestational age (based on last menstrual period), were available for 96% of the subjects from hospital records. Data on social circumstances in adulthood included subjects’ own social group, education, marital status, and household car ownership from 1960 census and were available for 96% of …

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  • Funding: the study was supported by grants from the UK Medical Research Council (grant no 9306778) and the Swedish Council for Working Life and Social Research. IK is currently funded by the Swedish Council for Working Life and Social Research. The funders were not involved in the study design or execution and the views and conclusions expressed in this manuscript are the responsibility of the authors.

  • Conflicts of interest: none declared.

  • The study was approved by the Uppsala University Ethics Committee.

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