Prenatal Famine Exposure and Adult Mortality From Cancer, Cardiovascular Disease, and Other Causes Through Age 63 Years
Prenatal Famine Exposure and Adult Mortality From Cancer, Cardiovascular Disease, and Other Causes Through Age 63 Years
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DOI：
10.1093/aje/kwu288
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发表时间：
2015-02-15
影响因子：
5
通讯作者：
Lumey, L. H.
中科院分区：
文献类型：
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作者：
Ekamper, Peter;van Poppel, Frans;Lumey, L. H.
生命早期的营养状况可能会影响成年人的健康，但以前对死亡率的研究仅限于小样本。我们评估了1944-1945年荷兰饥饿冬季期间产前/围产期饥荒暴露与1944-1947年出生的41，096名男性63岁时死亡率之间的关系，并在18岁时对荷兰的普遍兵役进行了检查。在这些人中，有22,952人是在荷兰饥荒期间出生在6个受影响的城市;其余的人作为未暴露的对照。考克斯比例风险模型用于估计癌症、心脏病、其他自然原因和外部原因死亡的风险比。在1，853，023人年的随访后，我们记录了1，938例癌症死亡，1，040例心脏病死亡，1，418例其他自然原因死亡，523例外部原因死亡。我们发现，在产前饥饿暴露后，癌症或心血管疾病的死亡率没有增加。然而，在妊娠早期饥饿暴露后，其他自然原因（风险比= 1.24，95%置信区间：1.03，1.49）和外部原因（风险比= 1.46，95%置信区间：1.09，1.97）导致的死亡率增加。需要对该队列进行进一步随访，以提供更准确的妊娠期和极早期营养失调后特定死亡原因所致死亡率的风险估计。
Nutritional conditions in early life may affect adult health, but prior studies of mortality have been limited to small samples. We evaluated the relationship between pre-/perinatal famine exposure during the Dutch Hunger-Winter of 1944-1945 and mortality through age 63 years among 41,096 men born in 1944-1947 and examined at age 18 years for universal military service in the Netherlands. Of these men, 22,952 had been born around the time of the Dutch famine in 6 affected cities; the remainder served as unexposed controls. Cox proportional hazards models were used to estimate hazard ratios for death from cancer, heart disease, other natural causes, and external causes. After 1,853,023 person-years of follow-up, we recorded 1,938 deaths from cancer, 1,040 from heart disease, 1,418 from other natural causes, and 523 from external causes. We found no increase in mortality from cancer or cardiovascular disease after prenatal famine exposure. However, there were increases in mortality from other natural causes (hazard ratio = 1.24, 95% confidence interval: 1.03, 1.49) and external causes (hazard ratio = 1.46, 95% confidence interval: 1.09, 1.97) after famine exposure in the first trimester of gestation. Further follow-up of the cohort is needed to provide more accurate risk estimates of mortality from specific causes of death after nutritional disturbances during gestation and very early life.