No relation between coronary artery disease or electrocardiographic markers of disease in middle age and prenatal exposure to the Dutch famine of 1944–5

Lumey, L. H.; Martini, Lauren; Myerson, Merle; Stein, Aryeh D.; Prineas, Ronald J.

doi:10.1136/heartjnl-2012-302419

Cited by 33 publications

(32 citation statements)

References 45 publications

(39 reference statements)

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“…C. Ravelli et al, 1998; Ravelli, van der Meulen, Osmond, Barker, & Bleker, 1999; Stein et al, 2007) Taken together, clinic-based studies on cardiovascular risk do not show a relation with famine. (Lumey, Martini, Myerson, Stein, & Prineas, 2012; Roseboom et al, 2000) Survival data from one clinic population was recently become published (Van Abeelen et al, 2012) but those results are hard to interpret because of limited sample size. Increases in weight and diabetes prevalence have been confirmed in a comprehensive review of morbidity outcomes from prenatal famine studies world-wide as discussed elsewhere.…”

Section: Introductionmentioning

confidence: 99%

Independent and additive association of prenatal famine exposure and intermediary life conditions with adult mortality between age 18–63 years

Ekamper

Poppel

Stein

et al. 2014

Social Science & Medicine

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Objectives To quantify the relation between prenatal famine exposure and adult mortality, taking into account mediating effects of intermediary life conditions. Design Historical follow-up study. Setting The Dutch famine (Hunger Winter) of 1944–1945 which occurred towards the end of WWII in occupied Netherlands. Study population From 408,015 Dutch male births born 1944–1947, examined for military service at age 18, we selected for follow-up all men born at the time of the famine in six affected cities in the Western Netherlands (n=25,283), and a sample of unexposed time (n=10,667) and place (n=9,087) controls. These men were traced and followed for mortality through the national population and death record systems. Outcome measure All-cause mortality between ages 18 and 63 years using Cox proportional hazards models adjusted for intermediary life conditions. Results An increase in mortality was seen after famine exposure in early gestation (HR 1.12; 95% confidence interval (CI): 1.01 to 1.24) but not late gestation (HR 1.04; 95% CI: 0.96 to 1.13). Among intermediary life conditions at age 18 years, educational level was inversely associated with mortality and mortality was elevated in men with fathers with a manual versus non-manual occupations (HR 1.08; CI: 1.02 to 1.16) and in men who were declared unfit for military service (HR 1.44; CI: 1.31 to 1.58). Associations of intermediate factors with mortality were independent of famine exposure in early life and associations between prenatal famine exposure and adult mortality were independent of social class and education at age 18. Conclusions Timing of exposure in relation to the stage of pregnancy may be of critical importance for later health outcomes independent of intermediary life conditions.

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Section: Introductionmentioning

confidence: 99%

Independent and additive association of prenatal famine exposure and intermediary life conditions with adult mortality between age 18–63 years

Ekamper

Poppel

Stein

et al. 2014

Social Science & Medicine

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“…Schreier et al found a protective effect from exposure to war and coronary heart disease: exposed women between 63 and 80 years and men between 50 and 54 years of age had higher survival rates than the unexposed (Schreier et al 2011). Other studies of famine found no increase in coronary artery disease (Lumey et al 2012), no effect on blood pressure (Roseboom et al 1999), no increased cardiovascular mortality (Ekamper et al 2015), and a weak but significant increase in hypertension prevalence among the exposed (OR 1.44, 95 % CI 1.04, 2.0) (Stein et al 2006).…”

Section: Resultsmentioning

confidence: 91%

A systematic review of the health effects of prenatal exposure to disaster

Saulnier

Brolin

2015

Int J Public Health

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Due to the lack of variety in type of events studied, as well as large methodological variation, it is difficult to draw firm conclusions from existing literature. However, our systematic review highlights the potential of evaluating secondary data, both to accentuate research gaps in the field and to increase the understanding of what effects various types of disasters potentially have on the unborn child.

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“…This suggests that the protective effect of caloric restriction in adulthood and animals on atherosclerosis and metabolic syndromes44 45 may not be readily translated to undernutrition in early life. Caloric restriction in different periods of life probably has different effects on atherosclerosis development, as suggested by findings from two studies on the Dutch famine which showed that famine exposure during adolescence increased the risk for cardiovascular events,14 whereas prenatal famine exposure did not 46…”

Section: Discussionmentioning

confidence: 99%

Famine in childhood and postmenopausal coronary artery calcification: a cohort study

Idris¹,

Uiterwaal

Schouw

et al. 2013

BMJ Open

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ObjectiveTo assess the effects of famine exposure during childhood on coronary calcium deposition and, secondarily, on cardiac valve and aortic calcifications.DesignRetrospective cohort.SettingCommunity.Patients286 postmenopausal women with individual measurements of famine exposure during childhood in the Netherlands during World War II.Intervention/exposureFamine exposure during childhood.Main outcome measuresCoronary artery calcifications measured by CT scan and scored using the Agatston method; calcifications of the aorta and cardiac valves (mitral and/or aortic) measured semiquantitatively. Logistic regression was used for coronary Agatston score of >100 or ≤100, valve or aortic calcifications as the dependent variable and an indicator for famine exposure as the independent variable. These models were also used for confounder adjustment and stratification based on age groups of 0–9 and 10–17 years.ResultsIn the overall analysis, no statistically significant association was found between severe famine exposure in childhood and a high coronary calcium score (OR 1.80, 95% CI 0.87 to 3.78). However, when looking at specific risk periods, severe famine exposure during adolescence was related to a higher risk for a high coronary calcium score than non-exposure to famine, both in crude (OR 3.47, 95% CI 1.00 to 12.07) and adjusted analyses (OR 4.62, 95% CI 1.16 to 18.43). No statistically significant association was found between childhood famine exposure and valve or aortic calcification (OR 1.66, 95% CI 0.69 to 4.10).ConclusionsFamine exposure in childhood, especially during adolescence, seems to be associated with a higher risk of coronary artery calcification in late adulthood. However, the association between childhood famine exposure and cardiac valve/aortic calcification is less clear.

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No relation between coronary artery disease or electrocardiographic markers of disease in middle age and prenatal exposure to the Dutch famine of 1944–5

Abstract: We see no relation between prenatal famine and adult CAD, Framingham risk, or any ECG predictors of increased cardiac disease risk.

Cited by 33 publications

References 45 publications

Independent and additive association of prenatal famine exposure and intermediary life conditions with adult mortality between age 18–63 years

Independent and additive association of prenatal famine exposure and intermediary life conditions with adult mortality between age 18–63 years

A systematic review of the health effects of prenatal exposure to disaster

Famine in childhood and postmenopausal coronary artery calcification: a cohort study

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