The risk of atrial fibrillation (AF) during middle age is increased among individuals born preterm or large for gestational age (LGA), according to a study of more than 8 million participants published in JAMA Pediatrics.¹

For this, the researchers obtained data of live singleton births from the national health registries of Sweden, Denmark and Finland. The Swedish registries provided data from 1973-2014 with follow-up till December 31, 2021; the Danish registries provided data from 1978-2016, with follow-up until December 31, 2016, while the Finnish registries gave information from 1987-2014 with follow-up till 2016. Through this study, they sought to determine a link between preterm birth (less than 37 gestational weeks), SGA (small for gestational age; <10th percentile birth weight for gestational age) or LGA (> 90th percentile birth weight for gestational age) with increased risks of future AF. The total number of participants was 8,012,433. Their maximum age was 49 years with a median age of 21 years.

Over the 174.4 million person-years of follow-up, a total of 11, 464 (0.14%) participants were diagnosed with AF; the median age of diagnosis was 29.3 years. Both preterm birth and LGA were linked to increased risk of AF in adulthood in the entire cohort and also in the sibling analyses with hazard ratio (HR) of 1.30 and 1.55 respectively. SGA children were more likely to be diagnosed with AF up till 18 years but not later on in life. Also, the association of AF risk and preterm birth was more robust in childhood than in adulthood.

This study showed that participants who were born preterm and were large for gestational age at birth were at a greater risk of being diagnosed with AF in their middle age. On the other hand, those who were born small for gestational age were at risk only during childhood but not as adults. According to the researchers, theirs is the first study to examine the link between birth outcomes and AF during childhood and adulthood. These findings suggest that individuals at risk may be carefully watched and advised lifestyle counselling right from an early age to prevent the disease.

Reference

1. Yang F, et al. Preterm birth, small for gestational age, and large for gestational age and the risk of atrial fibrillation up to middle age. JAMA Pediatr. 2023 Apr 24;e230083. doi: 10.1001/jamapediatrics.2023.0083.