title: Disease load at conception predicts survival in later epidemics in a historical French-Canadian cohort, suggesting functional trans-generational effects in humans.
abstract: OBJECTIVE
  Functional trans-generational and parental effects are potentially important determinants of health in several mammals. For humans, the existing evidence is weak. We investigate whether disease exposure triggers functional trans-generational response effects among humans by analyzing siblings who were conceived under different disease loads, and comparing their mortality in later epidemics. Under functional trans-generational response mechanisms, we expect that those who were conceived under high pathogenic stress load will have relatively low mortality during a later epidemic.
  
  
  METHODS
  We use data from the Registre de la Population du Québec Ancien, which covers the historical population living in St. Lawrence Valley, Québec, Canada. Children born in 1705-1724 were grouped according to their exposure during conception to the measles 1714-15 epidemic. The 1714-15 epidemic was followed by two mortality crises in 1729-1734. The cause of the first crises in 1729 is not exactly known. The second crisis in 1732 was caused by a smallpox epidemic. Using proportional hazard Cox regression models with multivariate adjustment and with fixed-effects approach that compare siblings, we analyze whether mortality in 1729-1734 is affected by exposure to the 1714-15 epidemic.
  
  
  RESULTS
  Children who were conceived during the peak of the measles epidemic of 1714-15 exhibited significantly lower mortality during the 1729-1734 crisis than those who were born before the 1714-15 epidemic (mortality hazard ratio 0.106, p<.05 in multivariate adjusted models; 0.142 p<.1 in sibling comparison models).
  
  
  CONCLUSIONS
  The results are consistent with a trans-generational mechanism that functionally responds to pathogen stress and suggest that early disease exposure may be protective later in life. Alternative explanations for the mortality patterns are discussed and shown to be problematic.
authors.affiliation: Max Planck Institute for Demographic Research, Rostock, Germany.
authors.forename: Kai
authors.initials: K
authors.lastname: Willführ
authors.affiliation: The London School of Economics and Political Science, London, United Kingdom.
authors.forename: Mikko
authors.initials: M
authors.lastname: Myrskylä
mesh_terms: D002170:Canada / Q000453:epidemiology; D015988:Cohort Effect; D015331:Cohort Studies; D058872:Epidemics; D005260:Female; D006801:Humans; D009026:Mortality; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects; D012042:Registries; D012044:Regression Analysis
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