The association between birth weight and incidence of heart failure in adults: a systematic review and meta-analysis

BACKGROUND: The link between birth weight and heart failure risk remains inconclusive. This study evaluates the relationship between birth weight categories and heart failure incidence in adults. METHODS: A systematic search was done on PubMed, Scopus, and Cochrane up to June 2024 included observational studies on adults Birth weight was categorized as low (0.9-3.38 kg), normal (3.38-4.00 kg), and high (≥4.00 kg). Heart failure incidence was analyzed using pooled hazard ratios (HR) with a random-effects model (95% CI). RESULTS: A total of four studies with 302,363 adults, with an average follow-up of 20.7 years, were included. Among participants, 3978 heart failure cases were identified, and 9.46% also had hypertension as a risk factor. In the pooled analysis of multivariate studies, individuals with low birth weight was associated with a 26% higher risk of heart failure (HR 1.26, 95% CI [1.17, 1.36], I² = 2%, p < 0.00001), compared to those with normal birth weight. In contrast, high birth weight did not show asignificant association with heart failure risk (HR 1.13, 95% CI [0.99, 1.29], I² = 20%, p = 0.08). Sensitivity analysis excluding a male-only study also showed no significant results (p > 0.05). No publication bias was found based on funnel plot assessment. CONCLUSIONS: Low birth weight is significantly associated with an increased risk of heart failure, highlighting the importance of recognizing birth weight history for early prevention efforts.Protocol Registration: https://www.crd.york.ac.uk/prospero identifier is CRD42024570800.