The relationship between birthweight and early age-related maculopathy: The atherosclerosis risk in communities study

Purpose: Birthweight is a marker of fetal growth, and has been linked to future risk of chronic diseases in adults. We examined the association between birthweight and age-related maculopathy (ARM). Methods: We studied 9730 adults from the population-based Atherosclerosis Risk in Communities study, of whom 4744 reported their exact birthweight and an additional 4986 provided categorical birthweight data (low, medium or high). We graded retinal photographs for presence of ARM using a modification of the Wisconsin ARM Grading System. Results: Early ARM was present in 479 (4.9%) adults. Among persons with exact birthweight data, there was no association between birthweight and early ARM (OR 1.1, 95% CI 0.9-1.3, for each kg increase in birthweight). However, in Whites, greater birthweight was associated with an increased risk of early ARM (OR 1.2, 95% CI 1.0-1.4, for each kilogram increase in birthweight), after adjustment for age, sex, smoking, blood pressure and education level. In analyses including additional participants who provided categorical birthweight data, the pattern of associations were similar but not statistically significant. We did not have sufficient numbers to examine associations for late ARM (n = 12) or in African-Americans separately. Conclusions: We found no association between birthweight and risk of early ARM in the whole population. Among the white participants, higher birthweight was associated with a slight increased risk of early ARM. These findings, if confirmed in other studies, suggest that fetal growth may be important in ARM development in white persons.