Prenatal exposure to wartime stress – long-term effect on coronary heart disease in later life

Abstract

Background. Increased rates of coronary heart disease (CHD) and cerebrovascular disease in later life have been repeatedly observed in subjects with low birth-weight. One possible reason for low birth-weight is prenatal stress. Little is known about the influence of prenatal stress on lifelong health outcomes. Aims. In this study we investigate the influence of prenatal stress on CHD and cerebrovascular disease incidence in adult life. Methods. We analysed data originating from the Helsinki Birth Cohort Study including hospital data from all men and women born between 1934 and 1944 (n = 13,039) in two hospitals of Helsinki. We estimated the hazard function based on Weibull distribution. We compared those exposed and unexposed to bombings while in utero in terms of lifelong CHD and cerebrovascular disease hazard. Results. In women exposed to bombings while in utero, we observed higher survival rates of both CHD and cerebrovascular disease than in those unexposed. In men, the results were ambiguous. Conclusions. Our findings suggest that prenatal exposure to severe stress may be associated with protective effects on the development of CHD in later life.

Seasonality and ambient temperature at time of conception in term-born individuals – influences on cardiovascular disease and obesity in adult life

“…The Dutch Hunger Winter study showed increased risks of coronary heart disease, hypertension, as well as type 2 diabetes in later life, while in the two other studies there were no associations found between malnutrition and cardiovascular disease or glucose intolerance. In our previous study of the effects of the bombings of Helsinki during World War II on subjects exposed while in utero, we observed slightly lower rates of both coronary heart disease and cerebrovascular disease in women, suggesting the effect of such a stress to be selective for developing these diseases if anything (4). In conclusion, the hardships of the war were multiple and their effect very hard to estimate.…”

“…Traditionally nutritional status, growth, living conditions and maternal stress have been focused upon (1–4). Environmental conditions including season and ambient temperature have so far not attracted much attention.…”

A systematic review of the health effects of prenatal exposure to disaster

“…Conversely, there was also evidence to suggest no association. Schreier et al found a protective effect from exposure to war and coronary heart disease: exposed women between 63 and 80 years and men between 50 and 54 years of age had higher survival rates than the unexposed (Schreier et al 2011). Other studies of famine found no increase in coronary artery disease (Lumey et al 2012), no effect on blood pressure (Roseboom et al 1999), no increased cardiovascular mortality (Ekamper et al 2015), and a weak but significant increase in hypertension prevalence among the exposed (OR 1.44, 95 % CI 1.04, 2.0) (Stein et al 2006).…”

Statistics, Biomedicine and Scientific Fraud

“…Therefore, the common linear regression analysis cannot be applied in this case. Incidentally, alike the incidence of coronary heart disease and cerebrovascular disease [17], birth weight does not follow a gaussian (i.e., normal) distribution, but is more likely to follow a Weibull hazard model, as birth weight could be considered the final outcome of the "battle for survival" of the fetus.…”