Roseboom T J, van der Meulen J H, Ravelli A C, van Montfrans G A, Osmond C, Barker D J, Bleker O P
Department of Clinical Epidemiology and Biostatistics, University of Amsterdam, The Netherlands.
J Hypertens. 1999 Mar;17(3):325-30. doi: 10.1097/00004872-199917030-00004.
Many studies have shown that low birth weight is associated with high blood pressure. The composition of the diet of pregnant women has also been found to affect blood pressure in their children. We assessed the effect of prenatal exposure to the Dutch famine of 1944-1945, during which the caloric intake from protein, fat and carbohydrate was proportionally reduced, on blood pressures in adults now aged about 50 years.
We measured blood pressures at home and in the clinic among people born at term in one hospital in Amsterdam, The Netherlands, between November 1 1943 and February 28 1947, for whom we had detailed birth records. Blood pressures of people exposed to famine during late (n = 120), mid-(n = 109) or early gestation (n = 68) were compared with those of people born in the year before or conceived in the year after the famine (unexposed subjects, n = 442). No effect of prenatal exposure on systolic and diastolic blood pressure was observed. The mean systolic blood pressure taken in the clinic in those exposed in late gestation, and adjusted for sex and age, was 1.3 mmHg higher than in the unexposed group (95% confidence interval -1.9 to 4.4). The mean systolic blood pressure differed by -0.6 mmHg (95% confidence interval -3.9 to 2.7) for those exposed in mid-gestation and -1.7 mmHg (95% confidence interval -5.6 to 2.2) for those exposed in early gestation. People who were small at birth had higher blood pressures. A 1 kg increase in birth weight was associated with a decrease of 2.7 mmHg (95% confidence interval 0.3 to 5.1) in systolic blood pressure. Analyses of blood pressures measured at home gave similar results.
High blood pressure was not linked to prenatal exposure to a balanced reduction of macronutrients in the maternal diet. However, it was linked to reduced fetal growth. We postulate that it might be the composition rather than the quantity of a pregnant woman's diet that affects her child's blood pressure in later life.
许多研究表明，低出生体重与高血压有关。还发现孕妇的饮食构成会影响其子女的血压。我们评估了产前暴露于1944 - 1945年荷兰饥荒对如今约50岁成年人血压的影响，在这场饥荒期间，蛋白质、脂肪和碳水化合物的热量摄入按比例减少。
我们在荷兰阿姆斯特丹一家医院测量了1943年11月1日至1947年2月28日足月出生且有详细出生记录的人群在家中和诊所的血压。将孕期晚期（n = 120）、中期（n = 109）或早期（n = 68）暴露于饥荒的人群的血压与饥荒前一年出生或饥荒后一年受孕的人群（未暴露组，n = 442）的血压进行比较。未观察到产前暴露对收缩压和舒张压有影响。孕期晚期暴露人群在诊所测量的经性别和年龄调整后的平均收缩压比未暴露组高1.3 mmHg（95%置信区间 -1.9至4.4）。孕期中期暴露人群的平均收缩压相差 -0.6 mmHg（95%置信区间 -3.9至2.7），孕期早期暴露人群相差 -1.7 mmHg（95%置信区间 -5.6至2.2）。出生时体重轻的人血压较高。出生体重每增加1 kg，收缩压降低2.7 mmHg（95%置信区间0.3至5.1）。在家中测量血压的分析得出了类似结果。
高血压与产前暴露于母亲饮食中宏量营养素的均衡减少无关。然而，它与胎儿生长受限有关。我们推测，可能是孕妇饮食的构成而非数量影响其子女成年后的血压。
