{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T12:38:19Z","timestamp":1788871099824,"version":"build-2803163510"},"reference-count":17,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2013,8,1]],"date-time":"2013-08-01T00:00:00Z","timestamp":1375315200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100002341","name":"Academy of Finland","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100002341","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100000274","name":"British Heart Foundation","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100000274","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100008403","name":"Finnish Medical Society Duodecim","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100008403","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100010135","name":"Finska L\u00e4kares\u00e4llskapet","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100010135","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100005744","name":"Foundation for Pediatric Research","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100005744","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100010125","name":"Jalmari and Rauha Ahokas Foundation","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100010125","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Juho Vainio Foundation"},{"DOI":"10.13039\/501100004212","name":"P\u00e4ivikki and Sakari Sohlberg Foundation","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100004212","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100004325","name":"Signe and Ane Gyllenberg Foundation","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100004325","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Yrj\u00f6 Jahnsson Foundation, and the Edwards Endowment"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["American J Hum Biol"],"published-print":{"date-parts":[[2013,9]]},"abstract":"\n Objectives<\/jats:title>\n \n Programming is the phenomenon whereby the body's structures and functions are permanently set by nutrition and other influences during early development. There is increasing evidence that programming in utero initiates cardiovascular disease. We hypothesized that susceptibility to developing chronic rheumatic heart disease on exposure to\n Streptococcus pyogenes<\/jats:italic>\n is programmed.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n We studied hospital admissions and deaths from chronic rheumatic heart disease in 20,431 people born in Helsinki, Finland, during 1924\u20131944. One hundred and one people, 56 men, and 45 women, had chronic rheumatic heart disease.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n The disease was not associated with body or placental size at birth. It was, however, associated with a long umbilical cord so that the hazard ratio for the disease was 1.23 (95% CI 1.04\u20131.45,\n P<\/jats:italic>\n \u2009=\u20090.02) for every 10 cm increase in cord length. This association was present in people with mitral valve disease, hazard ratio 1.5 (1.20\u20131.89,\n P<\/jats:italic>\n \u2009<\u20090.0001), but not in people with aortic valve disease, hazard ratio 1.0 (0.76\u20131.33,\n P<\/jats:italic>\n \u2009=\u20090.97). Growing up in large households increased the risk of rheumatic heart disease.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n \n Longer umbilical cords have more spirals and a greater density of spirals per unit of length. Increased spiraling will increase the resistance to flow and the pressure load on the fetal heart. This could affect the development of the heart's valves and make them more vulnerable to the autoimmune process initiated by\n Streptococcus pyogenes<\/jats:italic>\n . The mitral valve may be more vulnerable than the aortic valve because the valve leaflets are larger and therefore have greater wall stress. Am. J. Hum. Biol., 25:655\u2013658, 2013. \u00a9 2013 Wiley Periodicals, Inc.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/ajhb.22425","type":"journal-article","created":{"date-parts":[[2013,8,1]],"date-time":"2013-08-01T08:18:16Z","timestamp":1375345096000},"page":"655-658","source":"Crossref","is-referenced-by-count":16,"title":["The developmental origins of chronic rheumatic heart disease"],"prefix":"10.1002","volume":"25","author":[{"given":"Johan G.","family":"Eriksson","sequence":"first","affiliation":[{"name":"Department of Chronic Disease Prevention National Institute for Health and Welfare Helsinki Finland"},{"name":"Department of General Practice and Primary Health Care University of Helsinki Finland"},{"name":"Vasa Central Hospital Finland"},{"name":"Folkh\u00e4lsan Research Centre Helsinki Finland"},{"name":"Unit of General Practice Helsinki University Central Hospital Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eero","family":"Kajantie","sequence":"additional","affiliation":[{"name":"Department of Chronic Disease Prevention National Institute for Health and Welfare Helsinki Finland"},{"name":"Hospital for Children and Adolescents Helsinki University Central Hospital and University of Helsinki Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David I.W.","family":"Phillips","sequence":"additional","affiliation":[{"name":"MRC Lifecourse Epidemiology Unit University of Southampton Southampton General Hospital Southampton UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clive","family":"Osmond","sequence":"additional","affiliation":[{"name":"MRC Lifecourse Epidemiology Unit University of Southampton Southampton General Hospital Southampton UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kent L.","family":"Thornburg","sequence":"additional","affiliation":[{"name":"Heart Research Center Oregon Health and Science University Portland Oregon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David J.P.","family":"Barker","sequence":"additional","affiliation":[{"name":"MRC Lifecourse Epidemiology Unit University of Southampton Southampton General Hospital Southampton UK"},{"name":"Heart Research Center Oregon Health and Science University Portland Oregon"},{"name":"Chair of Fetal Programming Zoology Department King Saud University Riyadh Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2013,8]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurjhf\/hfq069"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dys116"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa044160"},{"key":"e_1_2_6_5_1","volume-title":"Pathology 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