The Dutch famine birth cohort study: design, validation of exposure, and selected characteristics of subjects after 43 years follow‐up

Abstract

A historical birth cohort study of 1116 women born between August 1 1944 and April 15 1946 in the Wilhelmina Gasthuis hospital in Amsterdam, the Netherlands, was set up to study the short- and long-term effects of a limited period of extreme nutritional deprivation in the winter of 1944-1945 in the Western Netherlands. The degree of food deprivation is evidenced by a dramatic decline in third trimester pregnancy weight gain and infant birthweight. All women were traced and 84% (683/813) of survivors presently resident in the Netherlands agreed to be interviewed in their homes. There were no differences in characteristics at birth between interviewed and uninterviewed survivors. The women who were interviewed had 1299 offspring and were able to recall birthweight of all of them. Additional birthweight information from hospital and well-baby clinic (WBC) records is available for about half of the offspring. Since the famine was imposed on the entire population of a well-defined area, whose opportunities to obtain food elsewhere were severely restricted, and the women from this hospital cohort were predominantly lower middle class, the relationship between fetal nutrition and subsequent health outcomes in this cohort is not likely to be confounded by unmeasured attributes related to social class. In addition, selective losses to follow-up could be excluded, which makes the Dutch famine birth cohort a valuable resource for future studies in perinatal epidemiology.

Intrauterine calorie restriction affects placental DNA methylation and gene expression

“…This raises a possibility that dysregulation of DNA methylation of the Ptger1 gene in females may underlie the mechanism of preterm birth in maternal undernutrition. It has been clinically and experimentally shown that preterm birth rate increases in the cohort conceived during famine and animals fertilized under CR (8,20,35,36,51,54). Ptger1 mediates the effect of prostaglandin E2 (PGE2), an uterotonic agent that is clinically used for prevention of postpartum hemorrhage as well as induction of abortion.…”

Offspring Birth Weights after Maternal Intrauterine Undernutrition: A Comparison within Sibships

“…Details on the recruitment process have been published elsewhere (16). The obstetric records of all 1,116 females born between August 1, 1944, andApril 15, 1946, at the Department of Obstetrics and Gynecology, Wilhelmina Gasthuis Hospital (Amsterdam, The Netherlands), were identified.…”

Modifiable Maternal Exposures and Offspring Blood Pressure: A Review of Epidemiological Studies of Maternal Age, Diet, and Smoking

“…Even extreme exposures such as famine (15) and maternal smoking during pregnancy (16) result in birth weight changes of only a few hundred grams. However, it is likely that birth weight is a marker for other exposures (e.g., fetal nutrition, genetic factors, epigenetic factors) (17) and thus one would expect weak or modest associations of birth weight with later health related outcomes, but associations with the "real" developmental exposures should be stronger.…”