“Chinese baby laying on a bed” by simpleinsomnia is licensed under CC BY 2.0

Low Birth Weight Associated With More Diabetes and Hypertension in Adulthood

MedicalResearch.com Interview with:
“Chinese baby laying on a bed” by simpleinsomnia is licensed under CC BY 2.0Wanghong Xu, MD, PhD

Professor of Epidemiology
School of Public Health
Fudan University

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: The Developmental Origins of Health and Disease (DOHaD) hypothesis proposes that cardiovascular diseases and other chronic conditions in adulthood may be a consequence of an unfavorable intrauterine life, a relationship that is further modified by patterns of postnatal growth, environment, and lifestyle.

Based on the two large-scale cohort studies, the Shanghai Women’s Health Study and the Shanghai Men’s Health Study, we observed nonlinear associations for birth weight with baseline body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR), and low birth weight was linked with lower BMI, smaller WC, but larger WHR and WHtR.

An excess risk of T2DM and hypertension was observed for low birth weight (<2500 g) versus birth weight of 2500-3499 g since baseline and since birth. The results support the DoHad hypothesis, and indicate the importance of nutrition in early life on health in Chinese population. 

MedicalResearch.com: What should readers take away from your report?

1) Low birth weight was associated with lower BMI, smaller WC, but larger WHR and WHtR in Chinese population;

2) Higher risks of type 2 diabetes and hypertension were observed in Chinese men and women with low birth weight;

3) The epidemic of non-communicable diseases in China may be driven by the extremely rapid nutritional transition in the country during past decades;

4) In view of the disease prevention, low birth weight may be used to identify high-risk individuals, and should be reduced by improving maternal and child health to prevent obesity, diabetes and hypertension. 

MedicalResearch.com: What recommendations do you have for future research as a result of this work? 

Response: First, further studies should be conducted in Chinese population using birth cohort study design to confirm our results, and to better understand the mechanisms underlying;

Second, transgenerational studies, particularly those based on big data, are warranted to evaluate the effect of malnutrition in early life in one generation on the health of the next generation.

Third, trajectory studies could be conducted to predict changes in disease burden under different conditions of birth weight, which may help to identify key points, develop measures and make policy decisions.

MedicalResearch.com: Is there anything else you would like to add?

Response: My research group is trying to evaluate the associations of malnutrition in early life (indicated by low birth weight or exposure to the 1959-1961 Great Famine) on health consequences in adulthood, and explore its potential transgenerational effect.

So far, we found that :

1) A possible adverse but limited impact of exposure to the Great famine on the risk of breast cancer in Chinese women;

2) Chinese women exposed to famine, particularly after first birth, were more likely than those unexposed to be diagnosed with ER-PR-, ER-PR+, and ER+PR- breast cancer subtypes;

3) Maternal birthweight was positively associated with their daughters’ birthweight, with each kg increase linked to an average of 335 g (95% CI: 307, 363) increase in daughters’ birthweight.

However, maternal birthweight was not associated with their daughters’ body size and risk of hypertension in adulthood. We are working on the potential transgenerational effect on the risk of diabetes.


J Diabetes. 2018 Jun 11. doi: 10.1111/1753-0407.12800. [Epub ahead of print]

Prospective cohort studies of birth weight and risk of obesity, diabetes, and hypertension in adulthood among the Chinese population.

Xia Q1, Cai H2, Xiang YB3, Zhou P1, Li H3, Yang G2, Jiang Y1, Shu XO2, Zheng W2, Xu WH4. 

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Last Updated on August 25, 2018 by Marie Benz MD FAAD