Stein A D, Lumey L H
Department of International Health, Rollins School of Public Health of Emory University, Atlanta, GA, USA.
Hum Biol. 2000 Aug;72(4):641-54.
We examined the impact of famine-induced changes in maternal birth weight (MBW) on the association between MBW and offspring birth weight (OBW). Women born before, during, and after the Dutch Famine of 1944-1945 were interviewed at ages 41 to 46 years. Women (n = 582) and their children (n = 1,111) were included in the analysis if both mother and child were singleton and the child was not delivered preterm. Mean birth weight (BW) of women with first-trimester exposure (n = 110) was 154 g higher (p = 0.008), and mean BW of women with third-trimester exposure (n = 138) was 251 g lower (p < 0.001) than mean BW of unexposed women (n = 302). First-born offspring of women with first-trimester exposure were 72 g heavier (95% confidence interval [CI], -57 to 201; p = 0.27), and offspring of women with third-trimester exposure were 43 g lighter (95% CI, -170 to 79; p = 0.47) than offspring of unexposed women. Among unexposed women, each 100 g increase in MBW was associated with 25 g (95% CI, 12 to 37) increase in OBW (adjusted for maternal age, smoking, weight, and height and offspring sex). This association was attenuated in famine-exposed women (first-trimester change in OBW = 20 g per 100 g MBW; 95% CI, -1 to 41; third-trimester change in OBW = 14 g per 100 g MBW; 95% CI, -9 to 37). When MBW and trimester of maternal famine exposure were considered in a joint model, there was no independent effect of trimester of maternal famine exposure on OBW. Associations were less consistent for later-born offspring. We conclude that maternal prenatal famine exposure does not affect the association between maternal and offspring BW. Trimester of exposure was not a determinant of OBW, other than through its effect on MBW. Nevertheless, acute famine may impact on second-generation BW distributions indirectly, through its effect on the distribution of MBW.
我们研究了饥荒导致的母亲出生体重（MBW）变化对MBW与后代出生体重（OBW）之间关联的影响。对在1944 - 1945年荷兰饥荒之前、期间和之后出生的女性在41至46岁时进行了访谈。如果母亲和孩子均为单胎且孩子不是早产，则将这些女性（n = 582）及其孩子（n = 1111）纳入分析。孕早期暴露的女性（n = 110）的平均出生体重（BW）比未暴露女性（n = 302）高154 g（p = 0.008），孕晚期暴露的女性（n = 138）的平均BW比未暴露女性低251 g（p < 0.001）。孕早期暴露女性的头胎后代比未暴露女性的后代重72 g（95%置信区间[CI]，-57至201；p = 0.27），孕晚期暴露女性的后代比未暴露女性的后代轻43 g（95% CI，-170至79；p = 0.47）。在未暴露女性中，MBW每增加100 g，OBW增加25 g（95% CI，12至37）（根据母亲年龄、吸烟、体重、身高和后代性别进行调整）。这种关联在饥荒暴露女性中减弱（孕早期OBW每100 g MBW变化为20 g；95% CI，-1至41；孕晚期OBW每100 g MBW变化为14 g；95% CI，-9至37）。当在一个联合模型中考虑MBW和母亲饥荒暴露的孕期时，母亲饥荒暴露的孕期对OBW没有独立影响。对于晚出生的后代，关联不太一致。我们得出结论，母亲产前饥荒暴露不影响母亲与后代BW之间的关联。暴露的孕期不是OBW的决定因素，除非它对MBW有影响。然而，急性饥荒可能通过其对MBW分布的影响间接影响第二代BW分布。
