Association of low birth weight and preterm birth with the incidence of knee and hip arthroplasty for osteoarthritis
Arthritis Care & Research DOI: 10.1002/acr.22475
Sultana Monira Hussain1, Yuanyuan Wang1, Anita E. Wluka1, Jonathan E. Shaw2, Dianna J. Magliano2, Stephen Graves3,4 and Flavia M. Cicuttini1,*
1 Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, Melbourne, VIC, Australia
2 Baker IDI Heart and Diabetes Institute, Melbourne, VIC, Australia
3 Department of Orthopaedic, Repatriation General Hospital, Daw Park, SA, Australia
4 Australian Orthopaedic Association National Joint Replacement Registry, Discipline of Public Health, School of Population Health & Clinical Practice, University of Adelaide, SA, Australia
* Address for correspondence and reprint requests: Prof. Flavia M. Cicuttini Head, Musculoskeletal Unit School of Public Health and Preventive Medicine Monash University, Alfred Hospital Melbourne VIC 3004, Australia Phone: +61 3 990 30158 Fax: +61 3 990 30556 Email: flavia.cicuttini at monash.edu
Objectives: Low birth weight (LBW) and preterm birth have been associated with adverse adult outcomes including
- insulin resistance,
- cardiovascular disease and
- reduced bone mass.
It is unknown whether LBW and preterm birth affect the risk of osteoarthritis (OA). This study aims to examine whether LBW and preterm birth were associated with the incidence of knee and hip arthroplasty for OA.
Methods: 3,604 participants of the Australian Diabetes, Obesity and Lifestyle Study who reported their birth weight and history of preterm birth and were aged more than 40 years at the commencement of arthroplasty data collection. The incidence of knee and hip replacement for osteoarthritis during 2002-2011 was determined by linking cohort records to the Australian Orthopaedic Association National Joint Replacement Registry.
Results: One hundred and sixteen participants underwent knee arthroplasty and 75 underwent hip arthroplasty for OA.
- Low birth weight (yes vs. no, HR 2.04, 95% CI 1.11-3.75, p=0.02) and
- preterm birth (yes vs. no, HR 2.50, 95% CI 1.29-4.87, p=0.007)
were associated with increased incidence of hip arthroplasty independent of age, sex, BMI, education level, hypertension, diabetes, smoking and physical activity. No significant association was observed for knee arthroplasty.
Conclusions: Although these findings will need to be confirmed, they suggest that individuals born with LBW or preterm are at increased risk of hip arthroplasty for OA in adult life. The underlying mechanisms warrant further investigation.
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- Smoking reduces vitamin D - many studies
- Smoking associated with 9 ng less vitamin D age 40-50 – Nov 2014
- Smoking increased 2.7X the probability of low vitamin D levels in pregnancy – Sept 2013
- Search VitaminDWiki for "PRETERM BIRTH" 87 items as of Dec 2014
Increased cost of hip replacement, hypertension,cardiovascular disease etc. due to low birth weight probably need to be added to above calculation
- Could low birth weight and preterm birth be associated with significant burden of hip osteoarthritis? A systematic review June 2018, FREE PDF
- "Hip bone shape abnormalities examined included developmental hip dysplasia and immature hip, and hip osteoarthritis included osteophytes and total hip arthroplasty. A causal link between low birth weight or preterm birth and hip osteoarthritis was found. Of the 30,477 total hip arthroplasties performed for hip osteoarthritis in Australia in 2015, 5791 were estimated to be born preterm and ...."
- 19% had been preterm Note: about 10% of births are preterm
- Maternal smoking during pregnancy and birth outcomes in a sample of Romanian women Sept 2014
2.8X more likey to have preterm birth EVEN IF had given up smoking during pregnancy
- Why the United States preterm birth rate is declining. Dec 2014; 13% as of 2013
- Variety of possible reasons given, including smoking bans in some states
- Strategies to prevent preterm birth. Nov 2014 free full text online
Reduce smoking was one of the many strategies
Speculation - will be able to find an association between preterm births and the instigation of state-wide smoking bans
Smoking by adults in California
There have actually been
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