A1 Journal article (refereed)
Early growth, stress, and socioeconomic factors as predictors of the rate of multimorbidity accumulation across the life course : a longitudinal birth cohort study (2024)

Haapanen, M. J., Vetrano, D. L., Mikkola, T. M., Calderón-Larrañaga, A., Dekhtyar, S., Kajantie, E., Eriksson, J. G., & von Bonsdorff, M. B. (2024). Early growth, stress, and socioeconomic factors as predictors of the rate of multimorbidity accumulation across the life course : a longitudinal birth cohort study. Lancet Healthy Longevity, 5(1), e56-e65. https://doi.org/10.1016/S2666-7568(23)00231-3

JYU authors or editors

Publication details

All authors or editorsHaapanen, Markus J.; Vetrano, Davide L.; Mikkola, Tuija M.; Calderón-Larrañaga, Amaia; Dekhtyar, Serhiy; Kajantie, Eero; Eriksson, Johan G.; von Bonsdorff, Mikaela B.

Journal or seriesLancet Healthy Longevity



Publication year2024


Issue number1

Pages rangee56-e65


Publication countryUnited Kingdom

Publication languageEnglish


Publication open accessOpenly available

Publication channel open accessPartially open access channel

Publication is parallel published (JYX)https://jyx.jyu.fi/handle/123456789/92426


Early growth, stress, and socioeconomic factors are associated with future risk of individual chronic diseases. It is uncertain whether they also affect the rate of multimorbidity accumulation later in life. This study aimed to explore whether early life factors are associated with the rate at which chronic diseases are accumulated across older age.

In this national birth cohort study, we studied people born at Helsinki University Central Hospital, Helsinki, Finland between Jan 1, 1934, and Dec 31, 1944, who attended child welfare clinics in the city, and were living in Finland in 1971. Individuals who had died or emigrated from Finland before 1987 were excluded, alongside participants without any registry data and who died before the end of the registry follow-up on Dec 31, 2017. Early anthropometry, growth, wartime parental separation, and socioeconomic factors were recorded from birth, child welfare clinic, or school health-care records, and Finnish National Archives. International Classification of Diseases codes of diagnoses for chronic diseases were obtained from the Care Register for Health Care starting from 1987 (when participants were aged 42–53 years) until 2017. Linear mixed models were used to study the association between early-life factors and the rate of change in the number of chronic diseases over 10-year periods.

From Jan 1, 1934, to Dec 31, 2017, 11 689 people (6064 [51·9%] men and 5625 [48·1%] women) were included in the study. Individuals born to mothers younger than 25 years (β 0·09; 95% CI 0·06–0·12), mothers with a BMI of 25–30 kg/m2 (0·08; 0·05–0·10), and mothers with a BMI more than 30 kg/m2 (0·26; 0·21–0·31) in late pregnancy accumulated chronic diseases faster than those born to older mothers (25–30 years) and those with a BMI of less than 25 kg/m2. Individuals with a birthweight less than 2·5 kg (0·17; 0·10–0·25) and those with a rapid growth in height and weight from birth until age 11 years accumulated chronic diseases faster during their life course. Additionally, paternal occupational class (manual workers vs upper-middle class 0·27; 0·23–0·30) and wartime parental separation (0·24; 0·19–0·29 for boys; 0·31; 0·25–0·36 for girls) were associated with a faster rate of chronic disease accumulation.

Our findings suggest that the foundation for accumulating chronic diseases is established early in life. Early interventions might be needed for vulnerable populations, including war evacuee children and children with lower socioeconomic status.

Keywordschronic diseasesdiseasessocioeconomic factorsearly childhood

Contributing organizations

Ministry reportingYes

Reporting Year2023

Preliminary JUFO rating1

Last updated on 2024-03-07 at 01:26