No relation between coronary artery disease or electrocardiographic markers of disease in middle age and prenatal exposure to the Dutch famine of 1944-5.
OBJECTIVE
Associations between prenatal famine and coronary artery disease (CAD) have been examined before with inconsistent results. For further evaluation, we examined multiple cardiac risk markers in adult men and women with prenatal exposure to the Dutch famine of 1944-5.


METHODS
Birth cohort study of 407 men and women with prenatal famine exposure, 344 born before or after the famine as time controls, and 324 unexposed siblings as family controls. Study subjects underwent standardised interviews and clinical examinations at age approximately 58 years.


METHODS
CAD events from medical history and medical and electrocardiographic (ECG) markers of CAD risk, including 10-year (Framingham) estimates for myocardial infarction and coronary heart disease death, major and minor ECG abnormalities, ECG estimates of left ventricular hypertrophy and left ventricular mass, cardiac autonomic neuropathy measures including the QT index, resting heart rate, heart rate variability from subsequent N-N intervals, and ECG markers of minor T-wave abnormalities, changes in QRS/T frontal plane angle and ST-segment.


RESULTS
No increase was seen in CAD risk (HR 1.17; 95% CI 0.73 to 1.88), Framingham risk (OR 1.14; 95% CI 0.90 to 1.44) or in ECG outcomes, adjusting for age and sex. Left ventricular mass estimated with body size was elevated by 3.78 g (95% CI 0.91 to 6.64) after prenatal famine, but showed a 0.65 g decrease (95% CI -2.63 to 1.34) when adjusted for body mass index.


CONCLUSIONS
We see no relation between prenatal famine and adult CAD, Framingham risk, or any ECG predictors of increased cardiac disease risk.
Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th Street, New York, NY 10032, USA. lumey@columbia.edu
L H
LH
Lumey
Lauren H
LH
Martini
Merle
M
Myerson
Aryeh D
AD
Stein
Ronald J
RJ
Prineas
D017668:Age of Onset; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology*; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors