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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)
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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
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Copyright
© Cambridge University Press and the International Society for Developmental Origins of Health and Disease 2017 

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