title: Childhood exposure to the 1944-1945 Dutch famine and subsequent female reproductive function.
abstract: BACKGROUND
  Childhood caloric restriction may lead to permanent changes in the hypothalamo-pituitary-gonadal axis, which could lead to impaired female reproductive ability. We assessed the effect of childhood exposure to the 1944-1945 Dutch famine on subsequent female reproductive function.
  
  
  METHODS
  This was a population-based cohort study in Utrecht, The Netherlands. Between 1983 and 1985, 6030 women born between 1932-1941 were classified by questionnaire according to their famine exposure experiences. Dates of marriage, first and second childbirth, and information on a medical reason for having no children or fewer children than wanted were available from questionnaires, as well as ages and type of menopause.
  
  
  RESULTS
  Severe famine exposure during childhood significantly decreased chances of first and second childbirth at any given time after marriage or first childbirth [adjusted hazard ratios (HR) 0.86, 95% confidence interval (CI) 0.76-0.96; and HR 0.87, 95% CI 0.78-0.97, respectively). Risk of a medical reason for having no or fewer children than wanted was increased in the severely exposed (odds ratio 1.88; 95% CI 1.29-2.74), as was the risk of a surgical menopause (HR 1.53; 95% CI 1.27-1.84).
  
  
  CONCLUSIONS
  Our findings support the presence of longstanding modest effects of childhood famine exposure on reproductive function in women.
authors.affiliation: Julius Center for Health Sciences and Primary Care, University Medical Center, GA Utrecht, The Netherlands. s.eliase@jc.azu.nl
authors.forename: Sjoerd G
authors.initials: SG
authors.lastname: Elias
authors.forename: Paulus A H
authors.initials: PA
authors.lastname: van Noord
authors.forename: Petra H M
authors.initials: PH
authors.lastname: Peeters
authors.forename: Isolde
authors.initials: I
authors.lastname: den Tonkelaar
authors.forename: Diederick E
authors.initials: DE
authors.lastname: Grobbee
mesh_terms: D000328:Adult; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D005298:Fertility / Q000502:physiology*; D006801:Humans; D007247:Infertility, Female / Q000453:epidemiology* / Q000503:physiopathology; D008393:Marriage / Q000706:statistics & numerical data; D008572:Menarche; D008593:Menopause; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D010298:Parity; D012307:Risk Factors; D013217:Starvation / Q000453:epidemiology* / Q000503:physiopathology; D011795:Surveys and Questionnaires