Background: Being born small-for-gestational-age (SGA) is associated with hypercholesterolemia in later life. It is possible that only certain subgroups of SGA are at elevated risk for hypercholesterolemia. We examined the associations between SGA subgroups based on levels of maternal smoking during pregnancy and adult hypercholesterolemia.
Methods: A subsample of 1625 adult offspring from the Collaborative Perinatal Project were followed at mean age 39 years. Subjects were classified by recorded fetal growth and maternal smoking status during pregnancy. Clinical diagnosis of hypercholesterolemia was obtained in interviews.
Results: Compared with the appropriate-for-gestational-age subgroup without maternal smoking during pregnancy, only SGA subgroups with maternal smoking during pregnancy had higher risk of hypercholesterolemia: for heavy smoking, adjusted hazard ratio = 2.5 (95% confidence interval = 1.4-4.3); moderate smoking, 1.7 (1.0-2.8); nonsmoking, 1.1 (0.5-2.1).
Conclusion: Only SGA infants whose mothers smoked during pregnancy had elevated risk of hypercholesterolemia in adulthood.