HRs for associations between perinatal or familial factors and acute MI in young adulthood (ages 18–38 years)
| MI (N=239) | No MI (N=1 970 630) | Adjusted model 1* | Adjusted model 2† | |||
|---|---|---|---|---|---|---|
| HR (95% CI) | p Value | HR (95% CI) | p Value | |||
| Sex | ||||||
| Male | 170 (71.1) | 1 012 179 (51.4) | 2.32 (1.76 to 3.07) | <0.001 | 2.33 (1.76 to 3.08) | <0.001 |
| Female | 69 (28.9) | 958 451 (48.6) | 1.00 | 1.00 | ||
| Fetal growth (SD) | ||||||
| <−2 | 32 (13.4) | 73 213 (3.7) | 2.36 (1.78 to 3.12) | <0.001 | 2.48 (1.66 to 3.71) | <0.001 |
| −2 to <−1 | 53 (22.2) | 318 924 (16.2) | 1.45 (1.05 to 1.99) | 0.02 | 1.31 (0.95 to 1.80) | 0.10 |
| −1 to <1 | 132 (55.2) | 1 303 022 (66.1) | 1.00 | 1.00 | ||
| >1 | 22 (9.2) | 275 471 (14.0) | 0.84 (0.53 to 1.32) | 0.45 | 0.86 (0.54 to 1.34) | 0.50 |
| Per additional 1 SD (trend test) | 0.71 (0.63 to 0.80) | <0.001 | 0.78 (0.69 to 0.87) | <0.001 | ||
| Gestational age at birth weeks) | ||||||
| <37 | 16 (6.7) | 105 380 (5.3) | 1.44 (0.86 to 2.39) | 0.17 | 1.05 (0.62 to 1.78) | 0.85 |
| 37–41 | 188 (78.7) | 1 680 683 (85.3) | 1.00 | 1.00 | ||
| >42 | 35 (14.6) | 184 567 (9.4) | 1.29 (0.90 to 1.84) | 0.17 | 1.12 (0.77 to 1.62) | 0.55 |
| Per additional 1 week (trend test) | 1.00 (0.93 to 1.07) | 0.94 | 1.02 (0.96 to 1.10) | 0.49 | ||
| Birth weight (g) | ||||||
| <2500 | 22 (9.2) | 76 073 (3.9) | 2.71 (1.74 to 4.22) | <0.001 | 2.26 (1.31 to 3.91) | 0.004 |
| 2500–3999 | 182 (76.2) | 1 557 944 (79.1) | 1.00 | 1.00 | ||
| >4000 | 35 (14.6) | 336 613 (17.1) | 0.85 (0.59 to 1.22) | 0.37 | 0.86 (0.59 to 1.24) | 0.42 |
| Per 1000 g (trend test) | 0.58 (0.46 to 0.71) | <0.001 | 0.61 (0.47 to 0.79) | <0.001 | ||
| Birth length (cm) | ||||||
| <48 | 36 (15.1) | 194 611 (9.9) | 1.78 (1.24 to 2.55) | 0.002 | 1.43 (0.95 to 2.15) | 0.09 |
| 48–52 | 176 (73.6) | 1 452 732 (73.7) | 1.00 | 1.00 | ||
| >53 | 27 (11.3) | 311 614 (15.8) | 0.59 (0.39 to 0.89) | 0.01 | 0.59 (0.39 to 0.89) | 0.01 |
| Unknown | 0 (0.0) | 11 673 (0.6) | NE | NE | NE | NE |
| Per cm (trend test) | 0.91 (0.87 to 0.95) | <0.001 | 0.93 (0.88 to 0.98) | 0.006 | ||
| Multiple birth status | ||||||
| Singleton | 228 (95.4) | 1 933 363 (98.1) | 1.00 | 1.00 | ||
| Twin or higher order | 11 (4.6) | 37 267 (1.9) | 2.91 (1.59 to 5.34) | 0.001 | 2.25 (1.19 to 4.25) | 0.01 |
| Birth order | ||||||
| 1 | 104 (43.5) | 824 763 (41.9) | 1.00 | 1.00 | ||
| 2 | 81 (33.9) | 718 165 (36.4) | 0.90 (0.68 to 1.21) | 0.49 | 0.90 (0.67 to 1.22) | 0.50 |
| >3 | 54 (22.6) | 427 702 (21.7) | 1.15 (0.83 to 1.60) | 0.40 | 0.95 (0.66 to 1.35) | 0.76 |
| Per 1 higher birth order (trend test) | 1.05 (0.89 to 1.24) | 0.56 | 0.96 (0.81 to 1.15) | 0.69 | ||
| Maternal age at delivery (years) | ||||||
| <20 | 15 (6.3) | 60 519 (3.1) | 1.53 (0.89 to 2.66) | 0.13 | 1.19 (0.66 to 2.13) | 0.57 |
| 20–24 | 79 (33.1) | 463 299 (23.5) | 1.31 (0.97 to 1.78) | 0.08 | 1.17 (0.85 to 1.61) | 0.33 |
| 25–29 | 86 (36.0) | 740 024 (37.6) | 1.00 | 1.00 | ||
| 30–34 | 41 (17.1) | 491 763 (25.0) | 0.83 (0.57 to 1.21) | 0.33 | 0.80 (0.55 to 1.17) | 0.25 |
| >35 | 18 (7.5) | 215 025 (10.9) | 1.00 (0.60 to 1.67) | 0.99 | 0.83 (0.50 to 1.39) | 0.49 |
| Per each higher category (trend test) | 0.85 (0.75 to 0.97) | 0.01 | 0.88 (0.76 to 1.00) | 0.06 | ||
| Maternal marital status | ||||||
| Married/cohabiting | 147 (61.5) | 1 460 869 (74.1) | 1.00 | 1.00 | ||
| Never married | 67 (28.0) | 297 826 (15.1) | 1.12 (0.84 to 1.50) | 0.43 | 0.95 (0.71 to 1.27) | 0.72 |
| Divorced/widowed | 25 (10.5) | 211 935 (10.8) | 1.18 (0.77 to 1.81) | 0.44 | 1.06 (0.69 to 1.63) | 0.79 |
| Maternal education (years) | ||||||
| <9 | 89 (37.2) | 469 016 (23.8) | 1.00 | 1.00 | ||
| 10–11 | 91 (38.1) | 759 486 (38.5) | 0.84 (0.63 to 1.13) | 0.25 | 0.94 (0.70 to 1.26) | 0.68 |
| 12–14 | 30 (12.6) | 445 715 (22.6) | 0.52 (0.34 to 0.79) | 0.002 | 0.68 (0.44 to 1.05) | 0.08 |
| >15 | 10 (4.2) | 214 053 (10.9) | 0.30 (0.16 to 0.58) | <0.001 | 0.48 (0.23 to 0.97) | 0.04 |
| Unknown | 19 (7.9) | 82 360 (4.2) | 1.45 (0.88 to 2.38) | 0.15 | 1.34 (0.81 to 2.24) | 0.26 |
| Per each higher category (trend test) | 0.71 (0.61 to 0.82) | <0.001 | 0.81 (0.69 to 0.96) | 0.02 | ||
| Paternal education (years) | ||||||
| <9 | 99 (41.4) | 538 983 (27.4) | 1.00 | 1.00 | ||
| 10–11 | 70 (29.3) | 632 026 (32.1) | 0.86 (0.64 to 1.17) | 0.35 | 0.92 (0.67 to 1.25) | 0.58 |
| 12–14 | 37 (15.5) | 437 514 (22.2) | 0.55 (0.37 to 0.80) | 0.002 | 0.68 (0.46 to 1.00) | 0.05 |
| >15 | 13 (5.4) | 260 435 (13.2) | 0.33 (0.18 to 0.59) | <0.001 | 0.54 (0.29 to 1.02) | 0.06 |
| Unknown | 20 (8.4) | 101 672 (5.2) | 1.28 (0.79 to 2.07) | 0.32 | 1.214 (0.74 to 1.99) | 0.45 |
| Per each higher category (trend test) | 0.72 (0.63 to 0.83) | <0.001 | 0.83 (0.71 to 0.97) | 0.02 | ||
| Cardiovascular and chromosomal anomalies or syndromes | ||||||
| No | 221 (92.5) | 1 955 286 (99.2) | 1.00 | 1.00 | ||
| Yes | 18 (7.5) | 15 344 (0.8) | 12.75 (7.89 to 20.62) | <0.001 | 9.14 (5.60 to 14.90) | <0.001 |
| Diabetes | ||||||
| No | 205 (85.8) | 1 953 783 (99.1) | 1.00 | 1.00 | ||
| Yes | 34 (14.2) | 16 847 (0.9) | 16.55 (11.51 to 23.79) | <0.001 | 9.60 (6.35 to 14.50) | <0.001 |
| Hypertension | ||||||
| No | 215 (90.0) | 1 964 949 (99.7) | 1.00 | 1.00 | ||
| Yes | 24 (10.0) | 5681 (0.3) | 23.13 (15.16 to 35.30) | <0.001 | 7.55 (4.66 to 12.24) | <0.001 |
| Parental history of IHD | ||||||
| No | 169 (70.7) | 1 796 124 (91.1) | 1.00 | 1.00 | ||
| Yes | 70 (29.3) | 174 506 (8.9) | 2.73 (2.06 to 3.61) | <0.001 | 2.36 (1.78 to 3.13) | <0.001 |
*Adjusted for age and sex.
†Adjusted for age, sex, fetal growth, gestational age at birth, multiple birth, maternal and paternal education, cardiovascular and chromosomal anomalies or syndromes, diabetes, hypertension and parental history of IHD.
Birth weight and birth length were each examined in separate models as alternatives to the standardised fetal growth variable. The reference category for all variables is indicated by an HR of 1.00. Missing data were excluded for trend tests.
IHD, ischaemic heart disease; MI, myocardial infarction; NE, not estimable.