Born in winter or spring more susceptible to all-cause and cardiovascular disease death in rural areas of China: results from a 11.9-year follow-up study

There has been no evidence on the effects of birth season and birth month on mortality in China. We aimed to explore the association between birth season, birth month and all-cause and cardiovascular disease (CVD) death. A population-based sample of 21,338 Chinese rural participants aged ≥35 years at baseline was included in our analysis. Age and multivariable adjusted Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (95% CIs) for the relationship between astronomical birth season (autumn as the reference), birth month (November as the reference), and all-cause and CVD mortality. During a median follow-up period of 11.9 years, 2,207 people died from all-cause and 1,214 people were attributed to CVD death. In multivariable adjusted analyses, for all-cause death, spring and winter had HRs (95% CIs) of 1.134 (1.005–1.280) and 1.162 (1.038–1.301), respectively; January, March, May, and August had HRs (95% CIs) of 1.249 (1.027–1.518), 1.234 (1.008–1.512), 1.276 (1.037–1.571), and 1.232 (1.003–1.513), respectively. For CVD death, spring and winter with HRs (95% CIs) of mortality were 1.232 (1.048–1.449) and 1.174 (1.007–1.369), respectively; March with HR (95% CI) of mortality were 1.343 (1.030–1.750) (all P < 0.05). Our study indicated that people born in the winter or spring were significantly associated with all-cause and cardiovascular disease mortality in rural areas of China.