Timing of prenatal starvation in women and birth weight in their first and second born offspring: the Dutch Famine Birth Cohort study.

OBJECTIVES

To examine the long-term effects of severe in utero maternal undernutrition on offspring birth weight.

STUDY DESIGN

Birth weights were analyzed of 575 first born and 454 second born offspring of 683 women born in Amsterdam, the Netherlands, at the time of a severe famine at the end of World War II. In utero maternal undernutrition was defined separately for each pregnancy trimester by an average daily nutrition ration (supplied to the grandmother) of less than 1000 calories in that trimester of pregnancy.

RESULTS

Compared to controls, birth weights of first born infants of women prenatally exposed in the first trimester of pregnancy were 73 g heavier (95% CI: -64, 210), and birth weights of second born infants were 96 g lighter (95% CI: -249, 58). Birth weights of infants of women exposed in the second or third trimester were much closer to controls.

CONCLUSIONS

A substantial (200 g or more) impact of severe in utero maternal undernutrition on OBW can be ruled out. There may, however, be parity specific, moderate (50-100 g) effects of maternal undernutrition early in pregnancy on OBW. This suggestion requires confirmation in other populations.