Coronary heart disease after prenatal exposure to the Dutch famine, 1944–45
OBJECTIVE To assess the effect of prenatal exposure to maternal malnutrition on coronary heart disease in people born around the time of the Dutch famine, 1944–45. DESIGN Historical cohort study. SETTING Community study. PATIENTS Singletons born alive between November 1943 and February 1947 for whom...
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| Published in | Heart (British Cardiac Society) Vol. 84; no. 6; pp. 595 - 598 |
|---|---|
| Main Authors | , , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
London
BMJ Publishing Group Ltd and British Cardiovascular Society
01.12.2000
BMJ BMJ Publishing Group LTD |
| Subjects | |
| Online Access | Get full text |
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| Abstract | OBJECTIVE To assess the effect of prenatal exposure to maternal malnutrition on coronary heart disease in people born around the time of the Dutch famine, 1944–45. DESIGN Historical cohort study. SETTING Community study. PATIENTS Singletons born alive between November 1943 and February 1947 for whom detailed birth records were available. DESIGN The prevalence of coronary heart disease was compared between those exposed to famine in late gestation (n = 120), in mid-gestation (n = 108), or in early gestation (n = 68), and those born in the year before the famine or those conceived in the year after the famine (non-exposed subjects, n = 440). MAIN OUTCOME MEASURES Prevalence of coronary heart disease, defined as the presence of angina pectoris according to the Rose questionnaire, Q waves on the ECG, or a history of coronary revascularisation. RESULTS The prevalence of coronary heart disease was higher in those exposed in early gestation than in non-exposed people (8.8% v 3.2%; odds ratio adjusted for sex 3.0, 95% confidence interval (CI) 1.1 to 8.1). The prevalence was not increased in those exposed in mid gestation (0.9%) or late gestation (2.5%). People with coronary heart disease tended to have lower birth weights (3215 g v 3352 g, p = 0.13), and smaller head circumferences at birth (32.2 cmv 32.8 cm, p = 0.05), but the effect of exposure to famine in early gestation was independent of birth weight (adjusted odds ratio 3.2, 95% CI 1.2 to 8.8). CONCLUSIONS Although the numbers are very small, this is the first evidence suggesting that maternal malnutrition during early gestation contributes to the occurrence of coronary heart disease in the offspring. |
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| AbstractList | OBJECTIVE
—To assess the effect of prenatal exposure to maternal malnutrition on coronary heart disease in people born around the time of the Dutch famine, 1944-45.
DESIGN
—Historical cohort study.
SETTING
—Community study.
PATIENTS
—Singletons born alive between November 1943 and February 1947 for whom detailed birth records were available.
DESIGN
—The prevalence of coronary heart disease was compared between those exposed to famine in late gestation (n = 120), in mid-gestation (n = 108), or in early gestation (n = 68), and those born in the year before the famine or those conceived in the year after the famine (non-exposed subjects, n = 440).
MAIN OUTCOME MEASURES
—Prevalence of coronary heart disease, defined as the presence of angina pectoris according to the Rose questionnaire, Q waves on the ECG, or a history of coronary revascularisation.
RESULTS
—The prevalence of coronary heart disease was higher in those exposed in early gestation than in non-exposed people (8.8%
v
3.2%; odds ratio adjusted for sex 3.0, 95% confidence interval (CI) 1.1 to 8.1). The prevalence was not increased in those exposed in mid gestation (0.9%) or late gestation (2.5%). People with coronary heart disease tended to have lower birth weights (3215 g
v
3352 g, p = 0.13), and smaller head circumferences at birth (32.2 cm
v
32.8 cm, p = 0.05), but the effect of exposure to famine in early gestation was independent of birth weight (adjusted odds ratio 3.2, 95% CI 1.2 to 8.8).
CONCLUSIONS
—Although the numbers are very small, this is the first evidence suggesting that maternal malnutrition during early gestation contributes to the occurrence of coronary heart disease in the offspring.
Keywords:
coronary heart disease; fetal origins hypothesis; maternal malnutrition OBJECTIVE To assess the effect of prenatal exposure to maternal malnutrition on coronary heart disease in people born around the time of the Dutch famine, 1944–45. DESIGN Historical cohort study. SETTING Community study. PATIENTS Singletons born alive between November 1943 and February 1947 for whom detailed birth records were available. DESIGN The prevalence of coronary heart disease was compared between those exposed to famine in late gestation (n = 120), in mid-gestation (n = 108), or in early gestation (n = 68), and those born in the year before the famine or those conceived in the year after the famine (non-exposed subjects, n = 440). MAIN OUTCOME MEASURES Prevalence of coronary heart disease, defined as the presence of angina pectoris according to the Rose questionnaire, Q waves on the ECG, or a history of coronary revascularisation. RESULTS The prevalence of coronary heart disease was higher in those exposed in early gestation than in non-exposed people (8.8% v 3.2%; odds ratio adjusted for sex 3.0, 95% confidence interval (CI) 1.1 to 8.1). The prevalence was not increased in those exposed in mid gestation (0.9%) or late gestation (2.5%). People with coronary heart disease tended to have lower birth weights (3215 g v 3352 g, p = 0.13), and smaller head circumferences at birth (32.2 cmv 32.8 cm, p = 0.05), but the effect of exposure to famine in early gestation was independent of birth weight (adjusted odds ratio 3.2, 95% CI 1.2 to 8.8). CONCLUSIONS Although the numbers are very small, this is the first evidence suggesting that maternal malnutrition during early gestation contributes to the occurrence of coronary heart disease in the offspring. To assess the effect of prenatal exposure to maternal malnutrition on coronary heart disease in people born around the time of the Dutch famine, 1944-45. Historical cohort study. Community study. Singletons born alive between November 1943 and February 1947 for whom detailed birth records were available. The prevalence of coronary heart disease was compared between those exposed to famine in late gestation (n = 120), in mid-gestation (n = 108), or in early gestation (n = 68), and those born in the year before the famine or those conceived in the year after the famine (non-exposed subjects, n = 440). Prevalence of coronary heart disease, defined as the presence of angina pectoris according to the Rose questionnaire, Q waves on the ECG, or a history of coronary revascularisation. The prevalence of coronary heart disease was higher in those exposed in early gestation than in non-exposed people (8.8% v 3.2%; odds ratio adjusted for sex 3.0, 95% confidence interval (CI) 1.1 to 8.1). The prevalence was not increased in those exposed in mid gestation (0.9%) or late gestation (2.5%). People with coronary heart disease tended to have lower birth weights (3215 g v 3352 g, p = 0.13), and smaller head circumferences at birth (32.2 cm v 32.8 cm, p = 0.05), but the effect of exposure to famine in early gestation was independent of birth weight (adjusted odds ratio 3.2, 95% CI 1.2 to 8.8). Although the numbers are very small, this is the first evidence suggesting that maternal malnutrition during early gestation contributes to the occurrence of coronary heart disease in the offspring. OBJECTIVETo assess the effect of prenatal exposure to maternal malnutrition on coronary heart disease in people born around the time of the Dutch famine, 1944-45.DESIGNHistorical cohort study.SETTINGCommunity study.PATIENTSSingletons born alive between November 1943 and February 1947 for whom detailed birth records were available.DESIGNThe prevalence of coronary heart disease was compared between those exposed to famine in late gestation (n = 120), in mid-gestation (n = 108), or in early gestation (n = 68), and those born in the year before the famine or those conceived in the year after the famine (non-exposed subjects, n = 440).MAIN OUTCOME MEASURESPrevalence of coronary heart disease, defined as the presence of angina pectoris according to the Rose questionnaire, Q waves on the ECG, or a history of coronary revascularisation.RESULTSThe prevalence of coronary heart disease was higher in those exposed in early gestation than in non-exposed people (8.8% v 3.2%; odds ratio adjusted for sex 3.0, 95% confidence interval (CI) 1.1 to 8.1). The prevalence was not increased in those exposed in mid gestation (0.9%) or late gestation (2.5%). People with coronary heart disease tended to have lower birth weights (3215 g v 3352 g, p = 0.13), and smaller head circumferences at birth (32.2 cm v 32.8 cm, p = 0.05), but the effect of exposure to famine in early gestation was independent of birth weight (adjusted odds ratio 3.2, 95% CI 1.2 to 8.8).CONCLUSIONSAlthough the numbers are very small, this is the first evidence suggesting that maternal malnutrition during early gestation contributes to the occurrence of coronary heart disease in the offspring. OBJECTIVE To assess the effect of prenatal exposure to maternal malnutrition on coronary heart disease in people born around the time of the Dutch famine, 1944-45. DESIGN Historical cohort study. SETTING Community study. PATIENTS Singletons born alive between November 1943 and February 1947 for whom detailed birth records were available. DESIGN The prevalence of coronary heart disease was compared between those exposed to famine in late gestation (nâ[euro][per thousand]=â[euro][per thousand]120), in mid-gestation (nâ[euro][per thousand]=â[euro][per thousand]108), or in early gestation (nâ[euro][per thousand]=â[euro][per thousand]68), and those born in the year before the famine or those conceived in the year after the famine (non-exposed subjects, nâ[euro][per thousand]=â[euro][per thousand]440). MAIN OUTCOME MEASURES Prevalence of coronary heart disease, defined as the presence of angina pectoris according to the Rose questionnaire, Q waves on the ECG, or a history of coronary revascularisation. RESULTS The prevalence of coronary heart disease was higher in those exposed in early gestation than in non-exposed people (8.8% v 3.2%; odds ratio adjusted for sex 3.0, 95% confidence interval (CI) 1.1 to 8.1). The prevalence was not increased in those exposed in mid gestation (0.9%) or late gestation (2.5%). People with coronary heart disease tended to have lower birth weights (3215â[euro][per thousand]g v 3352â[euro][per thousand]g, pâ[euro][per thousand]=â[euro][per thousand]0.13), and smaller head circumferences at birth (32.2â[euro][per thousand]cmv 32.8â[euro][per thousand]cm, pâ[euro][per thousand]=â[euro][per thousand]0.05), but the effect of exposure to famine in early gestation was independent of birth weight (adjusted odds ratio 3.2, 95% CI 1.2 to 8.8). CONCLUSIONS Although the numbers are very small, this is the first evidence suggesting that maternal malnutrition during early gestation contributes to the occurrence of coronary heart disease in the offspring. |
| Author | Osmond, C Michels, R P J Schroeder-Tanka, J M van der Meulen, J H P Bleker, O P Barker, D J P Roseboom, T J van Montfrans, G A Ravelli, A C J |
| AuthorAffiliation | Department of Clinical Epidemiology and Biostatistics, Academic Medical Centre, University of Amsterdam, PO Box 22700, 1100 DE Amsterdam, Netherlands. t.j.roseboom@amc.uva.nl |
| AuthorAffiliation_xml | – name: Department of Clinical Epidemiology and Biostatistics, Academic Medical Centre, University of Amsterdam, PO Box 22700, 1100 DE Amsterdam, Netherlands. t.j.roseboom@amc.uva.nl |
| Author_xml | – sequence: 1 givenname: T J surname: Roseboom fullname: Roseboom, T J email: t.j.roseboom@amc.uva.nl – sequence: 2 givenname: J H P surname: van der Meulen fullname: van der Meulen, J H P email: t.j.roseboom@amc.uva.nl – sequence: 3 givenname: C surname: Osmond fullname: Osmond, C email: t.j.roseboom@amc.uva.nl – sequence: 4 givenname: D J P surname: Barker fullname: Barker, D J P email: t.j.roseboom@amc.uva.nl – sequence: 5 givenname: A C J surname: Ravelli fullname: Ravelli, A C J email: t.j.roseboom@amc.uva.nl – sequence: 6 givenname: J M surname: Schroeder-Tanka fullname: Schroeder-Tanka, J M email: t.j.roseboom@amc.uva.nl – sequence: 7 givenname: G A surname: van Montfrans fullname: van Montfrans, G A email: t.j.roseboom@amc.uva.nl – sequence: 8 givenname: R P J surname: Michels fullname: Michels, R P J email: t.j.roseboom@amc.uva.nl – sequence: 9 givenname: O P surname: Bleker fullname: Bleker, O P email: t.j.roseboom@amc.uva.nl |
| BackLink | http://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=810587$$DView record in Pascal Francis https://www.ncbi.nlm.nih.gov/pubmed/11083734$$D View this record in MEDLINE/PubMed |
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| Keywords | Human Prenatal Famine Mother Risk factor Cardiovascular disease Malnutrition Coronary heart disease |
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| References | Leon, Chenet, Shkolnikow 1997; 350 Eriksson, Forsen, Tuomilehto 1999; 318 Kwong, Roberts, Wild 1998; 513P Fall, Vijayakumar, Barker 1995; 310 Ravelli, van der Meulen, Osmond 1999; 70 Roseboom, van der Meulen, Ravelli 1999; 17 Seckl 1997; 62 Bakker, Sieben 1997; 40 Stanner, Bulmer, Andrès 1997; 315 Hales, Desai, Ozanne 1996; 24 Ravelli, van der Meulen, Michels 1998; 351 |
| References_xml | – volume: 315 start-page: 1342 year: 1997 article-title: Does malnutrition in utero determine diabetes and coronary heart disease in adulthood? Results from the Leningrad siege study, a cross sectional study. publication-title: BMJ contributor: fullname: Andrès – volume: 70 start-page: 811 year: 1999 article-title: Obesity at the age of 50 y in men and women exposed to famine prenatally. publication-title: Am J Clin Nutr contributor: fullname: Osmond – volume: 62 start-page: 89 year: 1997 article-title: Glucocorticoids, feto-placental 11β-hydroxysteroid dehydrogenase type 2, and the early life origins of adult disease. publication-title: Steroids contributor: fullname: Seckl – volume: 24 start-page: 341 year: 1996 article-title: Fishing in the stream of diabetes: from measuring insulin to the control of fetal organogenesis. publication-title: Biochem Soc Trans contributor: fullname: Ozanne – volume: 350 start-page: 383 year: 1997 article-title: Huge variation in Russian mortality rates 1984–1994: artefact, alcohol, or what? publication-title: Lancet contributor: fullname: Shkolnikow – volume: 310 start-page: 17 year: 1995 article-title: Weight in infancy and prevalence of coronary heart disease in adult life. publication-title: BMJ contributor: fullname: Barker – volume: 513P start-page: 88P year: 1998 article-title: Effect of maternal diet on embryonic development and fetal programming [abstract]. publication-title: J Physiol (Lond) contributor: fullname: Wild – volume: 351 start-page: 173 year: 1998 article-title: Glucose tolerance in adults after in utero exposure to the Dutch Famine. publication-title: Lancet contributor: fullname: Michels – volume: 40 start-page: 1 year: 1997 article-title: Maten voor prestige, sociaal-economische status en sociale klasse voor de standaard beroepenclassificatie 1992. publication-title: Sociale Wetenschappen contributor: fullname: Sieben – volume: 17 start-page: 325 year: 1999 article-title: Blood pressure in adults after prenatal exposure to famine. publication-title: J Hypertens contributor: fullname: Ravelli – volume: 318 start-page: 427 year: 1999 article-title: Catch-up growth in childhood and death from coronary heart disease: longitudinal study. publication-title: BMJ contributor: fullname: Tuomilehto |
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| SubjectTerms | Angina pectoris Biological and medical sciences Birth Weight Cardiology. Vascular system Cardiovascular disease Cardiovascular Medicine Cephalometry Cohort Studies Coronary Disease - embryology Coronary Disease - epidemiology Coronary heart disease Famine Female fetal origins hypothesis Gestational Age Health risk assessment Heart Humans Infant, Newborn Male maternal malnutrition Medical sciences Middle Aged Mortality Netherlands - epidemiology Placental Insufficiency - complications Pregnancy Pregnancy Complications Prenatal exposure Prenatal Exposure Delayed Effects Prevalence Risk Factors Starvation - complications Womens health |
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| Title | Coronary heart disease after prenatal exposure to the Dutch famine, 1944–45 |
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