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The placental origins of sudden cardiac death.
MedLine Citation:
PMID:  22997261     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVE: Most sudden cardiac deaths are due to cardiac arrhythmias, and abnormalities in the autonomic nervous system could underlie them. There is growing evidence that coronary heart disease is associated with alterations of fetal development as a result of variations in the processes of placentation that control fetal nutrition. We hypothesized that placental size would be associated with sudden cardiac death. METHODS: We examined sudden cardiac death within the Helsinki Birth Cohort of 13 345 men and women. RESULTS: One hundred eighty-seven (2.7%) men and 47 (0.7%) women had sudden unexplained cardiac death outside hospital. Sudden death was associated with a thin placenta, the hazard ratio being 1.47 [95% confidence interval (CI) 1.11-1.93, P = 0.006] for each g/cm(2) decrease in thickness. Sudden death was independently associated with poor educational attainment (P < 0.0001). Both of these associations were independent of socio-economic status in later life. CONCLUSION: Sudden death may be initiated by impaired development of the autonomic nervous system in utero as a result of shallow invasion of the spiral arteries in the maternal endometrium and consequent fetal malnutrition.
Authors:
David Jp Barker; Gail Larsen; Clive Osmond; Kent L Thornburg; Eero Kajantie; Johan G Eriksson
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-9-19
Journal Detail:
Title:  International journal of epidemiology     Volume:  -     ISSN:  1464-3685     ISO Abbreviation:  Int J Epidemiol     Publication Date:  2012 Sep 
Date Detail:
Created Date:  2012-9-21     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7802871     Medline TA:  Int J Epidemiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Heart Research Center and Moore Institute, Oregon Health and Science University, Portland, OR, USA, MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, Hampshire, UK, Chair of Fetal Programming, Zoology Department, College of Science, King Saud University, Riyadh, Saudi Arabia, Department of Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland, Hospital for Children and Adolescents, Helsinki University Central Hospital, Helsinki, Finland, Department of General Practice and Primary Health Care, Institute of Clinical Medicine, University of Helsinki, Helsinki, Finland, Vasa Central Hospital, Vasa, Finland, Folkhälsan Research Centre, Helsinki, Finland and Unit of General Practice, Helsinki University Central Hospital, Helsinki, Finland.
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