Roseboom T J, van der Meulen J H, Osmond C, Barker D J, Ravelli A C, Bleker O P
Department of Clinical Epidemiology, Academic Medical Centre, Amsterdam, The Netherlands.
Paediatr Perinat Epidemiol. 2001 Jul;15(3):220-5. doi: 10.1046/j.1365-3016.2001.00336.x.
Early life events may affect adult survival. We studied the effect of prenatal exposure to the Dutch famine 1944--45 on survival among 2254 people born in Amsterdam. Mortality up to age 50 was highest among those born before the famine (15.2%) and among those exposed to famine in late gestation (14.6%). It was lower among those exposed in mid- (11.2%) or early gestation (11.5%), and was lowest among those conceived after the famine (7.2%). These differences were caused by effects on mortality in the first year after birth and were mainly related to nutrition and infections. There was no effect of exposure to famine on mortality after the age of 18. The hazard ratio was 1.4 [0.8, 2.3] for those born before the famine, 1.1 [0.5, 2.3] for those exposed in late gestation, 0.8 [0.3, 1.8] for those exposed in mid-gestation and 1.1 [0.5, 2.5] in those exposed in early gestation compared with those conceived after the famine. We could not demonstrate effects of prenatal exposure to famine on cause-specific mortality after the age of 18. Because prenatal exposure to famine is linked to cardiovascular risk factors and disease, increased cardiovascular mortality in the future may be expected.
早年经历可能会影响成年后的生存情况。我们研究了1944 - 1945年荷兰饥荒期间产前暴露对阿姆斯特丹出生的2254人的生存情况的影响。在饥荒前出生的人群（15.2%）以及在孕期后期暴露于饥荒的人群（14.6%）中，50岁前的死亡率最高。在孕期中期（11.2%）或早期（11.5%）暴露于饥荒的人群中死亡率较低，而在饥荒后受孕的人群中死亡率最低（7.2%）。这些差异是由出生后第一年的死亡率影响造成的，并且主要与营养和感染有关。18岁以后，暴露于饥荒对死亡率没有影响。与饥荒后受孕的人群相比，饥荒前出生人群的风险比为1.4 [0.8, 2.3]，孕期后期暴露人群的风险比为1.1 [0.5, 2.3]，孕期中期暴露人群的风险比为0.8 [0.3, 1.8]，孕期早期暴露人群的风险比为1.1 [0.5, 2.5]。我们无法证明产前暴露于饥荒对18岁以后特定病因死亡率的影响。由于产前暴露于饥荒与心血管危险因素和疾病有关，预计未来心血管死亡率会增加。
