{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T03:57:28Z","timestamp":1768535848143,"version":"3.49.0"},"reference-count":40,"publisher":"American Academy of Pediatrics (AAP)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,1,1]]},"abstract":"<jats:sec>\n                  <jats:title>BACKGROUND<\/jats:title>\n                  <jats:p>Exposure to childhood out-of-home care (foster family and residential care) is associated with an increased risk of ill-health and disability in adulthood, but the risk for cardiovascular disease has not previously been studied longitudinally.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>This was a national cohort study generated from linkage of a range of population-based registers, resulting in a national cohort of 881\u2009731 of whom 26\u2009310 (3.0%) had a history of out-of-home care. The study population, born 1972 to 1981, was followed from age 18 to age 39 to 48 years for hospitalizations and death.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>After adjusting for year of birth and maternal education, individuals with a history of childhood out-of-home-care experienced a doubling of the risk for coronary disease (hazard ratio; 95% confidence interval: 2.05; 1.74\u20132.41) and stroke (hazard ratio 1.85; 1.59\u20132.15), compared with the general population, with similar estimates for men and women. Women with a history of out-of-home care had a more than doubled risk for cigarette smoking in early pregnancy, with a relative risk of 2.26; (2.18\u20132.34) and a moderately increased risk for gestational diabetes relative risk 1.49 (1.19\u20131.86). There was marked attenuation (40% to 90%) in effect estimates for disease and risk factors after further control for cohort members educational achievement at age 15\u201316 years.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>A history of childhood out-of-home care was associated with a doubled risk of early cardiovascular disease events. Cigarette smoking and educational underachievement were the main identified risk factors.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1542\/peds.2023-063174","type":"journal-article","created":{"date-parts":[[2024,1,24]],"date-time":"2024-01-24T08:06:55Z","timestamp":1706083615000},"source":"Crossref","is-referenced-by-count":3,"title":["Cardiovascular Disease and Risk Factors in Individuals With a History of Out-of-home Care"],"prefix":"10.1542","volume":"153","author":[{"given":"Anders","family":"Hjern","sequence":"first","affiliation":[{"name":"aClinical Epidemiology and Department of Medicine, Karolinska Institutet, Stockholm, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bo","family":"Vinnerljung","sequence":"additional","affiliation":[{"name":"bDepartment of Social Work, Stockholm University, Stockholm, 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