Hostname: page-component-76fb5796d-vvkck Total loading time: 0 Render date: 2024-04-26T09:10:56.742Z Has data issue: false hasContentIssue false
  • English
  • Français

The risk of stroke after prenatal exposure to famine

Published online by Cambridge University Press:  29 June 2017

J. Horenblas ,
S. R. de Rooij  and
T. J. Roseboom
J. Horenblas*
Affiliation:
Department of Obstetrics and Gynaecology, Academic Medical Center, Amsterdam, The Netherlands
S. R. de Rooij
Affiliation:
Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical Center, Amsterdam, The Netherlands Department of Public Health, Academic Medical Center, Amsterdam, The Netherlands
T. J. Roseboom
Affiliation:
Department of Obstetrics and Gynaecology, Academic Medical Center, Amsterdam, The Netherlands Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical Center, Amsterdam, The Netherlands
*
*Address for correspondence: J. Horenblas, AMC Afdeling voor Verloskunde Gynaecologie, Gynecology and Obstetrics, Meibergdreef 9, 1105 AZ, Amsterdam, North Holland, 1100 DD, The Netherlands. (Email j.horenblas@amc.nl)
Get access Rights & Permissions [Opens in a new window]

Abstract

Prenatal exposure to famine is associated with an increased risk of metabolic and cardiovascular diseases in the offspring at adult age. The aim of this study was to assess whether prenatal exposure to undernutrition increases the risk of stroke. This study was performed in the Dutch famine birth cohort, which consist of 2414 members who were born between 1943 and 1947 in the Netherlands. In a subsample of 1177 individuals, interviews were conducted using standardized questionnaires to obtain information about medical history (which included specific questions regarding stroke) and lifestyle. Information on stroke-related mortality was collected by linking the cohort with Statistics Netherlands. A Cox’s proportional hazard analysis was performed to calculate hazard ratios (HRs) comparing the incidence of non-fatal stroke between participants who were exposed, subdivided into early, mid and late gestation, and unexposed to famine prenatally. Three cohort members died of stroke. Of the 1177 subjects who responded to the questionnaires 49 (4.2%) survived a stroke. Unadjusted and adjusted HRs for the risk of non-fatal stroke did not show a significant difference between the unexposed and exposed subjects: HR 1.23 (95% CI 0.53–2.83), HR 1.23 (95% CI 0.53–2.82), HR 1.12 (95% CI 0.46–2.71) for those exposed in late, mid and early gestation, respectively. We were unable to find evidence for a major effect of prenatal exposure to famine on the risk of stroke in later life, although one should be aware that this study was underpowered and the study population too selected and young to identify smaller risks.

Keywords

cerebrovascular diseaseDutch famineprenatal undernutritionstroke
Type
Original Article
Information
Journal of Developmental Origins of Health and Disease , Volume 8 , Issue 6 , December 2017 , pp. 658 - 664
Check for updates
Copyright
© Cambridge University Press and the International Society for Developmental Origins of Health and Disease 2017 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Lozano, R, Naghavi, M, Foreman, K, et al. Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012; 380, 2095–2128.Google Scholar
2. Patel, SA, Winkel, M, Ali, MK, et al. Cardiovascular mortality associated with 5 leading risk factors: national and state preventable fractions estimated from survey data. Ann Intern Med. 2015; 163, 245–253.CrossRefGoogle ScholarPubMed
3. Harmsen, P, Lappas, G, Rosengren, A, et al. Long-term risk factors for stroke: twenty-eight years of follow-up of 7457 middle-aged men in Goteborg, Sweden. Stroke. 2006; 37, 1663–1667.CrossRefGoogle ScholarPubMed
4. Grysiewicz, RA, Thomas, K, Pandey, DK. Epidemiology of ischemic and hemorrhagic stroke: incidence, prevalence, mortality, and risk factors. Neurol Clin. 2008; 26, 871–895, vii.CrossRefGoogle ScholarPubMed
5. Ventura, NM, Jin, AY, Tse, MY, et al. Maternal hypertension programs increased cerebral tissue damage following stroke in adult offspring. Mol Cell Biochem. 2015; 408, 223–233.Google Scholar
6. Bygren, LO, Edvinsson, S, Brostrom, G. Change in food availability during pregnancy: is it related to adult sudden death from cerebro- and cardiovascular disease in offspring? Am J Hum Biol. 2000; 12, 447–453.Google Scholar
7. Herrera-Garcia, G, Contag, S. Maternal preeclampsia and risk for cardiovascular disease in offspring. Curr Hypertens Rep. 2014; 16, 475.Google Scholar
8. Johnson, RC, Schoeni, RF. Early-life origins of adult disease: national longitudinal population-based study of the United States. Am J Public Health. 2011; 101, 2317–2324.CrossRefGoogle ScholarPubMed
9. Barker, DJ, Winter, PD, Osmond, C, et al. Weight in infancy and death from ischaemic heart disease. Lancet. 1989; 2, 577–580.Google Scholar
10. Hales, CN, Barker, DJ. The thrifty phenotype hypothesis. Br Med Bull. 2001; 60, 5–20.Google Scholar
11. Rich-Edwards, JW, Stampfer, MJ, Manson, JE, et al. Birth weight and risk of cardiovascular disease in a cohort of women followed up since 1976. BMJ. 1997; 315, 396–400.Google Scholar
12. Osmond, C, Barker, DJ, Winter, PD, et al. Early growth and death from cardiovascular disease in women. BMJ. 1993; 307, 1519–1524.CrossRefGoogle ScholarPubMed
13. Stein, CE, Fall, CH, Kumaran, K, et al. Fetal growth and coronary heart disease in south India. Lancet. 1996; 348, 1269–1273.Google Scholar
14. Smith, CJ, Ryckman, KK, Barnabei, VM, et al. The impact of birth weight on cardiovascular disease risk in the Women’s Health Initiative. Nutr Metab Cardiovasc Dis. 2016; 26, 239–245.Google Scholar
15. Roseboom, TJ, Painter, RC, van Abeelen, AF, et al. Hungry in the womb: what are the consequences? Lessons from the Dutch famine. Maturitas. 2011; 70, 141–145.CrossRefGoogle ScholarPubMed
16. Barker, DJ, Clark, PM. Fetal undernutrition and disease in later life. Rev Reprod. 1997; 2, 105–112.Google Scholar
17. Langley-Evans, SC, Sculley, DV. The association between birthweight and longevity in the rat is complex and modulated by maternal protein intake during fetal life. FEBS Lett. 2006; 580, 4150–4153.Google Scholar
18. Persson, E, Jansson, T. Low birth weight is associated with elevated adult blood pressure in the chronically catheterized guinea-pig. Acta Physiol Scand. 1992; 145, 195–196.Google Scholar
19. Woodall, SM, Johnston, BM, Breier, BH, et al. Chronic maternal undernutrition in the rat leads to delayed postnatal growth and elevated blood pressure of offspring. Pediatr Res. 1996; 40, 438–443.CrossRefGoogle ScholarPubMed
20. Hult, M, Tornhammar, P, Ueda, P, et al. Hypertension, diabetes and overweight: looming legacies of the Biafran famine. PLoS One. 2010; 5, e13582.Google Scholar
21. Yu, C, Wang, J, Li, Y, et al.Exposure to the Chinese famine in early life and hypertension prevalence risk in adults. J Hypertens. 2017; 35, 63–68.Google Scholar
22. Roseboom, TJ, van der Meulen, JH, Osmond, C, et al. Coronary heart disease after prenatal exposure to the Dutch famine, 1944–45. Heart. 2000; 84, 595–598.CrossRefGoogle Scholar
23. Roseboom, TJ, van der Meulen, JH, Ravelli, AC, et al. Effects of prenatal exposure to the Dutch famine on adult disease in later life: an overview. Twin Res. 2001; 4, 293–298.Google Scholar
24. Ravelli, AC, van Der Meulen, JH, Osmond, C, et al. Obesity at the age of 50 y in men and women exposed to famine prenatally. Am J Clin Nutr. 1999; 70, 811–816.CrossRefGoogle ScholarPubMed
25. van Abeelen, AF, Veenendaal, MV, Painter, RC, et al. Survival effects of prenatal famine exposure. Am J Clin Nutr. 2012; 95, 179–183.Google Scholar
26. Ravelli, AC, van der Meulen, JH, Michels, RP, et al. Glucose tolerance in adults after prenatal exposure to famine. Lancet. 1998; 351, 173–177.CrossRefGoogle ScholarPubMed
27. Painter, RC, Roseboom, TJ, Bleker, OP. Prenatal exposure to the Dutch famine and disease in later life: an overview. Reprod Toxicol. 2005; 20, 345–352.Google Scholar
28. Painter, RC, Roseboom, TJ, Bossuyt, PM, et al. Adult mortality at age 57 after prenatal exposure to the Dutch famine. Eur J Epidemiol. 2005; 20, 673–676.Google Scholar
29. de Rooij, SR, Painter, RC, Swaab, DF, et al. Sexual orientation and gender identity after prenatal exposure to the Dutch famine. Arch Sex Behav. 2009; 38, 411–416.CrossRefGoogle Scholar
30. Stein, AD, Zybert, PA, 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. 2006; 21, 759–765.Google Scholar
31. van Abeelen, AF, Elias, SG, Bossuyt, PM, et al. Cardiovascular consequences of famine in the young. Eur Heart J. 2012; 33, 538–545.CrossRefGoogle ScholarPubMed
32. Ariesen, MJ, Claus, SP, Rinkel, GJ, et al. Risk factors for intracerebral hemorrhage in the general population: a systematic review. Stroke. 2003; 34, 2060–2065.Google Scholar
33. Bogousslavsky, J, Van Melle, G, Regli, F. The Lausanne Stroke Registry: analysis of 1,000 consecutive patients with first stroke. Stroke. 1988; 19, 1083–1092.CrossRefGoogle Scholar
34. Caplan, LR. Intracerebral haemorrhage. Lancet. 1992; 339, 656–658.Google Scholar
35. Eriksson, JG, Forsen, T, Tuomilehto, J, et al. Early growth, adult income, and risk of stroke. Stroke. 2000; 31, 869–874.Google Scholar
36. Heshmati, A, Chaparro, MP, Koupil, I. Maternal pelvic size, fetal growth and risk of stroke in adult offspring in a large Swedish cohort. J Dev Orig Health Dis. 2016; 7, 108–113.Google Scholar