title: Cardiovascular morbidity and mortality in Finnish men and women separated temporarily from their parents in childhood--a life course study.
abstract: OBJECTIVE
  Early-life stress may influence health later in life. We examined morbidity and mortality from cardiovascular disease over 60 years in individuals separated temporarily from their parents in childhood due to World War II.
  
  
  METHODS
  We studied 12,915 members of the Helsinki Birth Cohort Study born from 1934 to 1944, of whom 1726 (13.4%) had been evacuated aboard without their parents to temporary foster families for an average of 1.8 (standard deviation = 1.1) years at an average age of 4.6 (standard deviation = 2.4) years. Data on parental separations were extracted from the Finnish National Archives. Information on use of medication for coronary heart disease and hypertension was derived from the National Register of Medication Reimbursement, and information on coronary events, stroke, and cardiovascular deaths was derived from Finnish Hospital Discharge Register and Causes of Death Register between Years 1971 and 2003.
  
  
  RESULTS
  Participants who were separated in childhood used medications for coronary heart disease more frequently than those who were not separated (7.2% versus 4.5%, respectively; hazard ratio [HR] = 1.29, 95% confidence interval [CI] = 1.04-1.59; p = .02). No associations between separation and all-cause mortality (HR = 1.04, 95% CI = 0.90-1.20) or cardiovascular mortality (HR = 0.94, 95% CI = 0.72-1.21) or hospitalizations for cardiovascular disease or stroke were observed.
  
  
  CONCLUSIONS
  Early-life stress may possibly be a factor predisposing to coronary heart disease decades later, but no evidence was found for increased risk of hospitalizations or mortality.
authors: Department of Chronic Disease Prevention, National Institute for Health and Welfare, PO Box 30, Helsinki, Finland. hanna.alastalo@thl.fi
authors: Hanna
authors: H
authors: Alastalo
authors: Katri
authors: K
authors: Räikkönen
authors: Anu-Katriina
authors: AK
authors: Pesonen
authors: Clive
authors: C
authors: Osmond
authors: David J P
authors: DJ
authors: Barker
authors: Kati
authors: K
authors: Heinonen
authors: Eero
authors: E
authors: Kajantie
authors: Johan G
authors: JG
authors: Eriksson
mesh_terms: D000367:Age Factors; D002318:Cardiovascular Diseases / Q000401:mortality*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D004641:Emigration and Immigration / Q000706:statistics & numerical data*; D005260:Female; D005387:Finland / Q000453:epidemiology; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008016:Life Change Events; D008297:Male; D008426:Maternal Deprivation; D009017:Morbidity; D010333:Paternal Deprivation; D016016:Proportional Hazards Models; D012042:Registries / Q000706:statistics & numerical data*; D012307:Risk Factors; D047789:World War II