title: Prenatal famine exposure and adult mortality from cancer, cardiovascular disease, and other causes through age 63 years.
abstract: Nutritional conditions in early life may affect adult health, but prior studies of mortality have been limited to small samples. We evaluated the relationship between pre-/perinatal famine exposure during the Dutch Hunger Winter of 1944-1945 and mortality through age 63 years among 41,096 men born in 1944-1947 and examined at age 18 years for universal military service in the Netherlands. Of these men, 22,952 had been born around the time of the Dutch famine in 6 affected cities; the remainder served as unexposed controls. Cox proportional hazards models were used to estimate hazard ratios for death from cancer, heart disease, other natural causes, and external causes. After 1,853,023 person-years of follow-up, we recorded 1,938 deaths from cancer, 1,040 from heart disease, 1,418 from other natural causes, and 523 from external causes. We found no increase in mortality from cancer or cardiovascular disease after prenatal famine exposure. However, there were increases in mortality from other natural causes (hazard ratio = 1.24, 95% confidence interval: 1.03, 1.49) and external causes (hazard ratio = 1.46, 95% confidence interval: 1.09, 1.97) after famine exposure in the first trimester of gestation. Further follow-up of the cohort is needed to provide more accurate risk estimates of mortality from specific causes of death after nutritional disturbances during gestation and very early life.
authors: Peter
authors: P
authors: Ekamper
authors: Frans
authors: F
authors: van Poppel
authors: Aryeh D
authors: AD
authors: Stein
authors: Govert E
authors: GE
authors: Bijwaard
authors: L H
authors: LH
authors: Lumey
mesh_terms: D000293:Adolescent; D000328:Adult; D001724:Birth Weight; D016022:Case-Control Studies; D005260:Female; D005500:Follow-Up Studies; D006331:Heart Diseases / Q000401:mortality*; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000401:mortality*; D009426:Netherlands / Q000453:epidemiology; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D011297:Prenatal Exposure Delayed Effects / Q000401:mortality*; D016016:Proportional Hazards Models; D018570:Risk Assessment; D012307:Risk Factors; D013217:Starvation / Q000453:epidemiology*
keywords: Dutch Hunger Winter; cohort studies; famine; fetal origins; prenatal exposure delayed effects; undernutrition
references: Am J Hum Biol. 2006 Nov-Dec;18(6):853-6
references: 17039469
references: Popul Stud (Camb). 1993 Mar;47(1):27-46
references: 11623195
references: Am J Clin Nutr. 2007 Mar;85(3):869-76
references: 17344511
references: Proc Natl Acad Sci U S A. 2008 Nov 4;105(44):17046-9
references: 18955703
references: Annu Rev Public Health. 2011;32:237-62
references: 21219171
references: Soc Sci Med. 2011 Sep;73(5):711-8
references: 21816529
references: Heart. 2012 Nov;98(22):1653-9
references: 22895645
references: Eur J Epidemiol. 2005;20(8):673-6
references: 16151880
references: Am J Epidemiol. 2005 Jun 1;161(11):1074-80
references: 15901628
references: Int J Cancer. 2005 Jul 1;115(4):611-7
references: 15700315
references: Ann Intern Med. 1999 Feb 16;130(4 Pt 1):278-84
references: 10068385
references: BMJ. 1998 Jul 25;317(7153):241-5
references: 9677213
references: Lancet. 1998 Jan 17;351(9097):173-7
references: 9449872
references: BMJ. 1997 Aug 16;315(7105):396-400
references: 9277603
references: BMJ. 1997 Aug 9;315(7104):341-7
references: 9270455
references: Am J Epidemiol. 1997 Jul 1;146(1):23-31
references: 9215220
references: Circulation. 1996 Dec 15;94(12):3246-50
references: 8989136
references: Lancet. 1996 Nov 30;348(9040):1478-80
references: 8942776
references: Soc Sci Med. 2014 Oct;119:232-9
references: 24262812
references: BMJ. 1996 Feb 17;312(7028):406-10
references: 8601111
references: BMJ. 1995 Jul 15;311(6998):171-4
references: 7613432
references: Diabetologia. 1994 Feb;37(2):150-4
references: 8163048
references: BMJ. 1991 Oct 26;303(6809):1019-22
references: 1954451
references: Int J Epidemiol. 1990 Jun;19(2):374-9
references: 2376450
references: Lancet. 1989 Sep 9;2(8663):577-80
references: 2570282
references: Rev Epidemiol Sante Publique. 1984;32(6):383-90
references: 6531501
references: Br J Prev Soc Med. 1977 Jun;31(2):91-5
references: 884401
references: Int J Epidemiol. 2004 Aug;33(4):831-6
references: 15166208
references: Eur J Popul. 1985 Nov;1(4):347-73
references: 12314072
references: Soc Hist Med. 1994 Aug;7(2):229-46
references: 11639327
references: Int J Epidemiol. 2001 Aug;30(4):678-83
references: 11511582
references: Heart. 2000 Dec;84(6):595-8
references: 11083734
references: Int J Obes Relat Metab Disord. 2000 Jun;24(6):667-72
references: 10878671
references: Am J Clin Nutr. 1999 Nov;70(5):811-6
references: 10539740
references: Am J Hum Biol. 2007 Jan-Feb;19(1):1-19
references: 17160980