Department of Epidemiology and Biostatistics, College of Public Health, University of South Florida, 13201 Bruce B Downs Blvd, MDC 56, Tampa, FL, 33612, USA,
Matern Child Health J. 2014 Apr;18(3):527-33. doi: 10.1007/s10995-013-1268-z.
Previous research is inconsistent about the effects of prenatal famine exposure on risk of adult hypertension. Follow-up of persons exposed to the 1959-1961 Chinese famine, the largest in human history, provides an opportunity to examine the long-term impact of prenatal famine exposure on adult cardiovascular disease (CVD). We investigated the effects of fetal-infant exposure to the famine on risk of hypertension in adulthood. We included 1,415 participants from the 2009 China Health and Nutrition Survey born September 1, 1956-December 31, 1964. Blood pressure (BP) measurements, self-reported previous diagnosis of hypertension and current anti-hypertension drug use were obtained from the survey. Differences in mean BP and risk of adult hypertension by famine exposure status were determined using linear and logistic regression analyses, after adjusting for confounders. Women with fetal-infant exposure to famine had higher mean systolic blood pressure (4.24 mmHg; 95% confidence interval (CI) 1.50-6.98) than those unexposed. They also had increased odds of a prior diagnosis of hypertension (odds ratio (OR) 2.16; 95% CI 1.16-4.02), and were more likely to be currently taking anti-hypertensive medications (OR 2.81; 95% CI 1.32-5.97) than unexposed women after adjusting for covariates. No statistically significant increases in mean BP or hypertension were seen among men. Exposure to famine during the fetal-infant period or early childhood has deleterious effects on adult health, but the effects may be greater for women. Gender-specific intervention strategies for CVD may be warranted for populations exposed to under-nutrition during critical time periods of fetal development.
先前的研究对于产前饥荒暴露对成人高血压风险的影响结果并不一致。对经历了 1959-1961 年中国饥荒（人类历史上最大的饥荒）的人群进行随访，为研究产前饥荒暴露对成人心血管疾病（CVD）的长期影响提供了机会。我们调查了胎儿-婴儿期暴露于饥荒对成人高血压风险的影响。我们纳入了 2009 年中国健康与营养调查中 1956 年 9 月 1 日至 1964 年 12 月 31 日出生的 1415 名参与者。调查获得了血压（BP）测量值、自我报告的既往高血压诊断和当前抗高血压药物使用情况。在校正混杂因素后，采用线性和逻辑回归分析确定了按饥荒暴露状况划分的平均 BP 差异和成人高血压风险。与未暴露于饥荒的女性相比，经历过胎儿-婴儿期饥荒暴露的女性平均收缩压更高（4.24mmHg；95%置信区间[CI]为 1.50-6.98）。她们也有更高的既往高血压诊断的可能性（比值比[OR]为 2.16；95%CI 为 1.16-4.02），并且在调整了协变量后，更有可能正在服用抗高血压药物（OR 为 2.81；95%CI 为 1.32-5.97）。男性的平均 BP 或高血压均未出现统计学显著增加。胎儿-婴儿期或幼儿期暴露于饥荒会对成人健康产生有害影响，但对于女性的影响可能更大。对于在胎儿发育关键时期暴露于营养不足的人群，可能需要采取针对 CVD 的性别特异性干预策略。
