Prenatal Growth and CKD in Older Adults: Longitudinal Findings From the Helsinki Birth Cohort Study, 1924-1944

Am J Kidney Dis. 2018 Jan;71(1):20-26. doi: 10.1053/j.ajkd.2017.06.030. Epub 2017 Aug 23.


Background: According to the Developmental Origins of Health and Disease (DOHaD) hypothesis, several noncommunicable diseases, including hypertension, type 2 diabetes, and coronary heart disease, have their origins in early life. Chronic kidney disease (CKD) has traditionally been assumed to develop as the result of an interaction between genetic and environmental factors, although more recently, the importance of factors present early in life has been recognized.

Study design: Longitudinal birth cohort study.

Setting & participants: 20,431 people born in 1924 to 1944 in Helsinki, Finland, who were part of the Helsinki Birth Cohort Study were followed up through their life course from birth until death or age 86 years.

Predictor: Prenatal growth and socioeconomic factors.

Outcomes: Death or hospitalization for CKD.

Results: Smaller body size at birth was associated with increased risk for developing CKD. Each standard deviation higher birth weight was associated with an HR for CKD of 0.82 (95% CI, 0.74-0.91; P<0.001). Associations with ponderal index at birth, placental weight, and birth length were also statistically significant (P<0.001, P<0.001, and P=0.002, respectively), but only among men. Prematurity also predicted increased risk for CKD.

Limitations: The study was restricted to people who were born in Helsinki in 1924 to 1944.

Conclusions: Smaller body size at birth was associated with increased risk for developing CKD in men. Prematurity was also associated with increased risk for CKD in women. These findings in the Helsinki Birth Cohort Study support the importance of early life factors in the development of CKD.

Keywords: Birth weight; Developmental Origins of Health and Disease (DOHaD); chronic kidney disease (CKD); early life factors; intrauterine growth restriction (IUGR); kidney; nephron number; noncommunicable disease; prenatal growth; programming.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged, 80 and over
  • Child
  • Child Development
  • Cohort Studies
  • Finland / epidemiology
  • Humans
  • Infant, Low Birth Weight / physiology*
  • Infant, Newborn
  • Infant, Premature / physiology*
  • Longitudinal Studies
  • Renal Insufficiency, Chronic* / diagnosis
  • Renal Insufficiency, Chronic* / epidemiology
  • Risk Factors
  • Sex Factors