Skip to main content
SpringerLink
Log in

Exposure to famine during gestation, size at birth, and blood pressure at age 59 y: evidence from the dutch famine

  • Perinatal Epidemiology
  • Published:
European Journal of Epidemiology Aims and scope Submit manuscript

Abstract

We compared blood pressure of individuals (mean age 59 y) born in western Holland between January 1945 and March 1946 (mothers exposed to the Dutch Famine before or during gestation; n = 359) to blood pressure of unexposed individuals born before or conceived after the famine (n = 299) or same-sex siblings of subjects in series 1 or 2 (n = 313). Mean (SD) systolic and diastolic blood pressure were 140.3 (20.3) and 85.8 (11.0) mmHg, respectively; prevalence of hypertension (prior diagnosis of hypertension or with measured systolic/diastolic blood pressure above 140/90 mmHg) was 61.8%. Birth weight was inversely related to systolic (−4.14 mmHg per kg; 95% confidence interval (CI) −7.24, −1.03; p < 0.01) and diastolic (−2.09 mmHg per kg; 95% CI −3.77, −0.41; p < 0.05) blood pressure and to the prevalence of hypertension (odds ratio 0.67 per kg, 95% CI: 0.49, 0.93) (all age- and sex-adjusted). Any famine exposure of at least 10 weeks duration was associated with elevated systolic (2.77 mmHg; 95% CI 0.25, 5.30; p < 0.05) and diastolic (1.27 mmHg; 95% CI −0.13, 2.66; p = 0.08) blood pressure and with hypertension prevalence (odds ratio 1.44; 95% CI 1.04, 2.00; p < 0.05) in age- and sex-adjusted models. Exposure to famine during gestation may predispose to the development of hypertension in middle age.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Adair L, Dahly D (2005) Developmental determinants of blood pressure in adults. Annu Rev Nutr 25: 407–434

    Article  PubMed  CAS  Google Scholar 

  2. Huxley R, Neil A, Collins R (2002) Unravelling the fetal origins hypothesis: Is there really an inverse association between birthweight and subsequent blood pressure? Lancet 360: 659–665

    Article  PubMed  Google Scholar 

  3. Joseph KS, Kramer MS (1996) Review of the evidence on fetal and early childhood antecedents of adult chronic disease. Epidemiol Rev 18: 158–174

    PubMed  CAS  Google Scholar 

  4. Osmond C, Barker DJ (2000) Fetal, infant, and childhood growth are predictors of coronary heart disease, diabetes, and hypertension in adult men and women. Environ Health Perspect 108(Suppl 3): 545–553

    PubMed  Google Scholar 

  5. Weinberg C (2005) Invited commentary: Barker meets Simpson. Am J Epidemiol 161: 33–35

    Article  PubMed  CAS  Google Scholar 

  6. Langley-Evans SC (2004) Experimental models of hypertension and cardiovascular disease. In: Langley-Evans SC (eds) Fetal Nutrition and Adult Disease: Programming of Chronic Disease through Fetal Exposure to Undernutrition. CABI International, Wallingford, UK

    Google Scholar 

  7. Leary SD, Ness AR, Emmett PM, et al. (2005) Maternal diet in pregnancy and offspring blood pressure. Arch Dis Child 90:492–493

    Article  PubMed  CAS  Google Scholar 

  8. Shiell AW, Campbell-Brown M, Haselden S, et al. (2001) High-meat, low-carbohydrate diet in pregnancy: Relation to adult blood pressure in the offspring. Hypertension 38: 1282–1288

    PubMed  CAS  Google Scholar 

  9. Huh SY, Rifas-Shiman SL, Kleinman KP, et al. (2005) Maternal protein intake is not associated with infant blood pressure. Int J Epidemiol 34: 378–384

    Article  PubMed  Google Scholar 

  10. Stein ZA, Susser M, Saenger G, et al. (1975) Famine and Human Development: The Dutch Hunger Winter of 1944–1945. Oxford University Press, New York

    Google Scholar 

  11. Lumey LH, Ravelli AC, Wiessing LG, et al. (1993) The Dutch famine birth cohort study: Design, validation of exposure, and selected characteristics of subjects after 43 years follow-up. Paediatr Perinat Epidemiol 7: 354–356

    Article  PubMed  CAS  Google Scholar 

  12. Roseboom TJ, van der Meulen JH, Ravelli AC, et al. (1999) Blood pressure in adults after prenatal exposure to famine. J Hypertension 17: 325–330

    Article  CAS  Google Scholar 

  13. Burger GCE, Drummond JC, Sandstead HR. Malnutrition and Starvation in Western Netherlands, September 1944 to July 1945, Parts I and II. ‚s-Gravenhage:Staatsuitgeverij, 1948

  14. De Jong L. Het Koninkrijk der Nederlanden in de tweede Wereldoorlog 1939–1945. Vol. Deel 10b. ‚s-Gravenhage: Staatsuitgeverij, 1981

  15. Lumey LH, van Poppel FW (1994) The Dutch famine of 1944–45: Mortality and morbidity in past and present generations. Soc Hist Med 7: 229–246

    PubMed  CAS  Google Scholar 

  16. Stein Z, Susser M (1975) Fertility, fecundity, famine: Food rations in the Dutch Famine 1944/45 have a causal relation to fertility, and probably to fecundity. Hum Biol 47:131–154

    PubMed  CAS  Google Scholar 

  17. Sindram IS (1953) De invloed van ondervoeding op de groel van de vrucht. Ned Tijdschr Verloskd Gynaecol 53: 30–48

    PubMed  CAS  Google Scholar 

  18. Stein AD, Ravelli AC, Lumey LH (1995) Famine, third-trimester pregnancy weight gain, and intrauterine growth: The Dutch Famine Birth Cohort Study. Hum Biol 67: 135–150

    PubMed  CAS  Google Scholar 

  19. Smith CA (1947) The effect of wartime starvation in Holland upon pregnancy and its product. Am J Obstet Gynec 53: 599–608

    Google Scholar 

  20. Stein AD, Zybert PA, van de Bor M, et al. (2004) Intrauterine famine exposure and body proportions at birth: The Dutch Hunger Winter. Int J Epidemiol 33: 831–836

    Article  PubMed  Google Scholar 

  21. O’Brien E, Waeber B, Parati G, et al. (2001) Blood pressure measuring devices: Recommendations of the European Society of Hypertension. Br Med J 322: 531–536

    Article  CAS  Google Scholar 

  22. Kloosterman GJ (1970) On intrauterine growth. Int J Gynaecol Obstet 8: 895–912

    Google Scholar 

  23. Stanner SA, Bulmer K, Andres C, et al. (1997) Does malnutrition in utero determine diabetes and coronary heart disease in adulthood? Results from the Leningrad siege study, a cross sectional study. Br Med J 315: 1342–1348

    CAS  Google Scholar 

  24. Stein AD, Kahn HS, Rundle A, Zyberet PA, van der Pal-De Bruin K, Lumey LH. Anthropometry in middle age following exposure to famine during gestation: Evidence from the Dutch Famine. Am J Clin Nutr (in press)

  25. Hernán MA, Hernández-Diaz S, Robins JM (2004) A structural approach to selection biasEpidemiology 15: 615–624

    Article  PubMed  Google Scholar 

  26. Rayco-Solon P, Fulford AJ, Prentice AM (2005) Differential effects of seasonality on preterm birth and intrauterine growth restriction in rural Africans. Am J Clin Nutr 81: 134–139

    PubMed  CAS  Google Scholar 

  27. Barker DJ, Bagby SP (2005) Developmental antecedents of cardiovascular disease: A historical perspective. J Am Soc Nephrol 16: 2537–2544

    Article  PubMed  Google Scholar 

  28. Gopalakrishnan GS, Gardner DS, Dandrea J, et al. (2005) Influence of maternal pre-pregnancy body composition and diet during early-mid pregnancy on cardiovascular function and nephron number in juvenile sheep. Brit J Nut 94: 938–947

    Article  CAS  Google Scholar 

  29. Langley-Evans SC, Welham SJ, Jackson AA (1999) Fetal exposure to a maternal low protein diet impairs nephrogenesis and promotes hypertension in the rat. Life Sci 64: 965–974

    Article  PubMed  CAS  Google Scholar 

  30. Manalich R, Reyes L, Herrera M, et al. (2000) Relationship between weight at birth and the number and size of renal glomeruli in humans: A histomorphometric studyKidney Int 58: 770–773

    Article  PubMed  CAS  Google Scholar 

  31. Painter RC, de Rooij SR, Bossuyt PM, Phillips DI, Osmond C, Barker DJ, Bleker OP, Roseboom TJ (2006) Blood pressure response to psychological stressors in adults after prenatal exposure to the Dutch famine. J Hypertens 24: 1771–1778

    Article  PubMed  CAS  Google Scholar 

  32. Susser M (1991) Maternal weight gain, infant birth weight, and diet: Causal sequences. Am J Clin Nutr 53: 1384–1396

    PubMed  CAS  Google Scholar 

Download references

Acknowledgements

Supported by grant RO1 HL067914 (PI: LHL), National Institutes of Health, USA. We thank the Vroedvrouwenscholen of Amsterdam and Rotterdam and the Obstetrics Department of the Leiden University Medical Center in Leiden for their help in accessing their archives.

Author information

Authors and Affiliations

  1. Rollins School of Public Health, Emory University, Atlanta, GA, 30322, USA

    Aryeh D. Stein

  2. Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th St, New York, NY, 10032, USA

    Patricia A. Zybert & L. H. Lumey

  3. TNO Quality of Life, Leiden, Netherlands

    Karin van der Pal-de Bruin

Authors
  1. Aryeh D. Stein
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Patricia A. Zybert
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Karin van der Pal-de Bruin
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. L. H. Lumey
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to L. H. Lumey.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Stein, A., Zybert, P., van der Pal-de Bruin, K. et al. Exposure to famine during gestation, size at birth, and blood pressure at age 59 y: evidence from the dutch famine. Eur J Epidemiol 21, 759–765 (2006). https://doi.org/10.1007/s10654-006-9065-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10654-006-9065-2

Keywords

Search

Navigation