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De Rooij SR, Bleker LS, Painter RC, Ravelli AC, Roseboom TJ. Lessons learned from 25 Years of Research into Long term Consequences of Prenatal Exposure to the Dutch famine 1944-45: The Dutch famine Birth Cohort. Int J Environ Health Res 2022; 32:1432-1446. [PMID: 33949901 DOI: 10.1080/09603123.2021.1888894] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Accepted: 02/08/2021] [Indexed: 06/12/2023]
Abstract
This paper describes the findings of a historical cohort study of men and women born around the time of the Dutch famine 1944-45. It provided the first direct evidence in humans of the lasting consequences of prenatal undernutrition. The effects of undernutrition depended on its timing during gestation, and the organs and tissues undergoing periods of rapid development at that time. Early gestation appeared to be particularly critical, with the effects of undernutrition being most apparent, even without reductions in size at birth. Undernutrition during gestation affected the structure and function of organs and tissues, altered behaviour and increased risks of chronic degenerative diseases. This demonstrates the fundamental importance of maternal nutrition during gestation as the building blocks for future health.
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Affiliation(s)
- Susanne R De Rooij
- Department of Epidemiology and Data Science, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
| | - Laura S Bleker
- Department of Epidemiology and Data Science, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
| | - Rebecca C Painter
- Department of Obstetrics and Gynaecology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
| | - Anita C Ravelli
- Department of Obstetrics and Gynaecology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
- Department of Medical Informatics, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
| | - Tessa J Roseboom
- Department of Epidemiology and Data Science, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
- Department of Obstetrics and Gynaecology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
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Abstract
PURPOSE The Dutch famine birth cohort study was set up to investigate the effects of acute maternal undernutrition of the 1944-1945 Dutch famine during the specific stages of gestation on later health, with a particular focus on chronic cardiovascular and metabolic diseases, ageing and mental health. PARTICIPANTS The Dutch famine birth cohort consists of 2414 singletons born alive and at term in the Wilhelmina Gasthuis in Amsterdam around the time of the Dutch famine (1943-1947) whose birth records have been kept. The cohort has been traced and studied since 1994, when the first data collection started. The cohort has been interviewed and physically examined in several waves of data collection since that time, allowing repeated measures of a wide range of phenotypic information as well as the collection of biological samples (blood, urine, buccal swabs), functional testing (of heart, lungs, kidney, HPA axis) and imaging of the brain (MRI) and vasculature (ultrasound). Additionally, genetic and epigenetic information was collected. Through linkage with registries, mortality and morbidity information of the entire cohort has been obtained. FINDINGS TO DATE Prenatal famine exposure had lasting consequences for health in later life. The effects of famine depended on its timing during the gestation and the organs and tissues developing at that time, with most effects after exposure to famine in early gestation. The effects of famine were widespread and affected the structure and function of many organs and tissues, resulted in altered behaviour and increased risks of chronic degenerative diseases and increased mortality. The effects of famine were independent of size at birth, which suggests that programming may occur without altering size at birth. FUTURE PLANS As the cohort ages, we will be assessing the effects of prenatal undernutrition on (brain) ageing, cognitive decline and dementia, as well as overall morbidity and mortality. REGISTRATION The Dutch famine birth cohort is not linked to a clinical trial.
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Affiliation(s)
- Laura S Bleker
- Epidemiology and Data Science, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Susanne R de Rooij
- Epidemiology and Data Science, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Rebecca C Painter
- Obstetrics & Gynaecology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Anita Cj Ravelli
- Medical Informatics; Obstetrics and Gynaecology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Tessa J Roseboom
- Epidemiology and Data Science; Obstetrics and Gynaecology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
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Bleker LS, Milgrom J, Sexton-Oates A, Parker D, Roseboom TJ, Gemmill AW, Holt CJ, Saffery R, Connelly A, Burger H, de Rooij SR. Cognitive Behavioral Therapy for Antenatal Depression in a Pilot Randomized Controlled Trial and Effects on Neurobiological, Behavioral and Cognitive Outcomes in Offspring 3-7 Years Postpartum: A Perspective Article on Study Findings, Limitations and Future Aims. Front Psychiatry 2020; 11:34. [PMID: 32116849 PMCID: PMC7031203 DOI: 10.3389/fpsyt.2020.00034] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Accepted: 01/13/2020] [Indexed: 12/11/2022] Open
Abstract
PURPOSE OF ARTICLE In a previous pilot randomized controlled trial including 54 pregnant women with depression, maternal mood improved after Cognitive Behavioural Therapy (CBT) compared to treatment as usual (TAU), showing medium to large effect sizes. The effect persisted up to 9 months postpartum, with infant outcomes also showing medium to large effects favoring CBT in various child domains. This perspective article summarizes the results of a follow-up that was performed approximately 5 years later in the same cohort, assessing the effects of antenatal Cognitive Behavioural Therapy for depression and anxiety on child buccal cell DNA-methylation, brain morphology, behavior and cognition. FINDINGS Children from the CBT group had overall lower DNA-methylation compared to children from the TAU group. Mean DNA-methylation of all NR3C1 promoter-associated probes did not differ significantly between the CBT and TAU groups. Children from the CBT group had a thicker right lateral occipital cortex and lingual gyrus. In the CBT group, Voxel-Based-Morphometry analysis identified one cluster showing increased gray matter concentration in the right medial temporal lobe, and fixel-based analysis revealed reduced fiber-bundle-cross-section in the Fornix, the Optical Tract, and the Stria Terminalis. No differences were observed in full-scale IQ or Total Problems Score. When the total of hypotheses tests in this study was considered, differences in DNA-methylation and brain measurements were no longer significant. SUMMARY Our explorative findings suggest that antenatal depression treatment decreases overall child DNA-methylation, increases cortical thickness, and decreases white matter fiber-bundle cross-section in regions involved in cognitive function and the stress response. Nevertheless, larger studies are warranted to confirm our preliminary conclusion that CBT in pregnancy alters neurobiological outcomes in children. Clinical relevance remains unclear as we found no effects of antenatal CBT on child behavior or cognition (yet).
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Affiliation(s)
- Laura S Bleker
- Academic Medical Centre, Department of Obstetrics and Gynecology, Amsterdam UMC, Amsterdam, Netherlands.,Academic Medical Centre, Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam UMC, Amsterdam, Netherlands
| | - Jeannette Milgrom
- Parent-Infant Research Institute, Austin Health, Melbourne, VIC, Australia.,Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, VIC, Australia
| | - Alexandra Sexton-Oates
- Murdoch Children's Research Institute-Cancer and Disease Epigenetics, Royal Children's Hospital, Melbourne, VIC, Australia
| | - Donna Parker
- Florey Institute of Neuroscience and Mental Health, Melbourne, VIC, Australia
| | - Tessa J Roseboom
- Academic Medical Centre, Department of Obstetrics and Gynecology, Amsterdam UMC, Amsterdam, Netherlands.,Academic Medical Centre, Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam UMC, Amsterdam, Netherlands
| | - Alan W Gemmill
- Parent-Infant Research Institute, Austin Health, Melbourne, VIC, Australia
| | - Christopher J Holt
- Parent-Infant Research Institute, Austin Health, Melbourne, VIC, Australia
| | - Richard Saffery
- Murdoch Children's Research Institute-Cancer and Disease Epigenetics, Royal Children's Hospital, Melbourne, VIC, Australia
| | - Alan Connelly
- Florey Institute of Neuroscience and Mental Health, Melbourne, VIC, Australia
| | - Huibert Burger
- University Medical Center Groningen, Department of General Practice, University of Groningen, Groningen, Netherlands.,Academic Medical Centre, Department of Psychiatry, Amsterdam UMC, Amsterdam, Netherlands
| | - Susanne R de Rooij
- Academic Medical Centre, Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam UMC, Amsterdam, Netherlands
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Bleker LS, de Rooij SR, Roseboom TJ. Prenatal Psychological Stress Exposure and Neurodevelopment and Health of Children. Int J Environ Res Public Health 2019; 16:ijerph16193657. [PMID: 31569453 PMCID: PMC6801715 DOI: 10.3390/ijerph16193657] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Accepted: 09/16/2019] [Indexed: 12/19/2022]
Affiliation(s)
- Laura S Bleker
- Department of Obstetrics and Gynaecology, Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam University Medical Centers, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.
| | - Susanne R de Rooij
- Department of Obstetrics and Gynaecology, Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam University Medical Centers, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.
| | - Tessa J Roseboom
- Department of Obstetrics and Gynaecology, Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam University Medical Centers, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.
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Bleker LS, Milgrom J, Gemmill AW, Roseboom TJ, de Rooij SR. A 7-year follow-up of antenatal depression treatment with cognitive behavioral therapy: A case report of maternal and child outcomes. SAGE Open Med Case Rep 2019; 7:2050313X19841463. [PMID: 31007918 PMCID: PMC6457020 DOI: 10.1177/2050313x19841463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Accepted: 03/12/2019] [Indexed: 11/17/2022] Open
Abstract
There are few studies of cognitive behavioral therapy for women with antenatal
depression including qualitative and quantitative data, and yet, individual
cases can provide valuable information on personal experiences of treatment
effectiveness and acceptability. The purpose of this case report is to explore
the long-term qualitative outcomes following cognitive behavioral therapy for
antenatal depression. A pregnant woman with a Diagnostic and Statistical Manual
of Mental Disorders diagnosis of depression was allocated to receive seven
sessions of cognitive behavioral therapy in a randomized controlled trial. We
describe her experiences and mood during treatment, at 12 weeks, 9 months,
2 years, and 7 years postpartum, as well as markers of her child’s development.
The woman’s mood symptoms were dramatically improved after treatment and
remained in the mild to moderate range until 7 years postpartum. Her child
showed overall age-appropriate development, with strengths highlighted in his
nonverbal and problem-solving ability. Relative weaknesses were in the
communication domain and his processing speed. This case report suggests that
psychological treatment for depression during pregnancy can be both acceptable
to women and potentially protective in the long term.
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Affiliation(s)
- Laura S Bleker
- Department of Obstetrics and Gynecology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.,Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Jeannette Milgrom
- Parent-Infant Research Institute, Austin Health, Melbourne, VIC, Australia.,Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, VIC, Australia
| | - Alan W Gemmill
- Parent-Infant Research Institute, Austin Health, Melbourne, VIC, Australia
| | - Tessa J Roseboom
- Department of Obstetrics and Gynecology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.,Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Susanne R de Rooij
- Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
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Bleker LS, de Rooij SR, Roseboom TJ. Malnutrition and depression in pregnancy and associations with child behaviour and cognitive function: a review of recent evidence on unique and joint effects 1. Can J Physiol Pharmacol 2019; 97:158-173. [PMID: 30624959 DOI: 10.1139/cjpp-2018-0381] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Accumulating studies suggest that prenatal experiences can shape a child's neurodevelopment. Malnutrition and depression occur in pregnancy relatively often and may affect child neurodevelopment independently as well as synergistically. We aimed to provide an overview of recent studies that have examined malnutrition and (or) depression in pregnancy and associations with child behavioural problems and cognitive function. We conducted a literature search in PubMed, using the following main search terms: "depression", "nutrition", "BMI", "pregnancy", "offspring", "cognition", and "behaviour". We included studies in human populations published from 2013 onwards. The literature search yielded 1531 articles, of which 55 were included in the current review. We presented the evidence on the associations between prenatal markers of nutritional status and (or) depression and child behaviour and (or) cognitive function. We additionally discussed interventions and mechanisms. Both malnutrition and depression in pregnancy are associated with increased externalizing behavioural problems and attentional deficits, and to some extent with poorer cognitive function in the child, but the evidence is not conclusive. Studies on synergistic effects of both factors on child behaviour and cognitive function are still scarce, and more research is needed. Potential shared mechanisms include the hypothalamic-pituitary-adrenal axis, the immune system, epigenetics, and oxidative stress.
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Affiliation(s)
- Laura S Bleker
- a Department of Obstetrics and Gynecology, Academic Medical Centre, Amsterdam UMC, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands.,b Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical Centre, Amsterdam UMC, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands
| | - Susanne R de Rooij
- b Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical Centre, Amsterdam UMC, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands
| | - Tessa J Roseboom
- a Department of Obstetrics and Gynecology, Academic Medical Centre, Amsterdam UMC, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands.,b Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical Centre, Amsterdam UMC, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands
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Bleker LS, van Dammen L, Leeflang MMG, Limpens J, Roseboom TJ, de Rooij SR. Hypothalamic-pituitary-adrenal axis and autonomic nervous system reactivity in children prenatally exposed to maternal depression: A systematic review of prospective studies. Neurosci Biobehav Rev 2018; 117:243-252. [PMID: 30366609 DOI: 10.1016/j.neubiorev.2018.05.033] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Revised: 05/25/2018] [Accepted: 05/29/2018] [Indexed: 12/25/2022]
Abstract
Depression is a common condition affecting up to 20% of all pregnant women, and is associated with subsequent developmental and behavioral problems in children, such as conduct disorder and ADHD. One proposed mechanism underlying these associations is modification of the fetal hypothalamic pituitary adrenal (HPA)-axis and the autonomic nervous system (ANS), resulting in altered responses to stress. This review examined the evidence regarding altered HPA-axis and ANS reactivity in children prenatally exposed to high maternal depressive symptoms. A systematic search was conducted in the electronic databases MEDLINE, EMBASE and PsycINFO, for studies published till 25 July 2017. A total of 13 studies comprising 2271 mother-infant dyads were included. None of the studies were suitable for meta-analysis. Risk of bias assessment showed low risk for four studies. Only three studies described an independent association between exposure to high maternal prenatal depressive symptoms and altered stress reactivity in children. There is limited evidence of an independent association between prenatal exposure to maternal depression and altered HPA or ANS reactivity in children.
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Affiliation(s)
- Laura S Bleker
- Academic Medical Centre, Departments of Obstetrics and Gynaecology, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands; Academic Medical Centre, Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
| | - Lotte van Dammen
- University of Groningen - University Medical Centre Groningen, Department of Obstetrics and Gynaecology, 9713 GZ, Groningen, The Netherlands; University of Groningen - University Medical Centre Groningen, Department of Epidemiology, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands
| | - Mariska M G Leeflang
- Academic Medical Centre, Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
| | - Jacqueline Limpens
- Academic Medical Centre, Department of Research Support - Medical Library, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
| | - Tessa J Roseboom
- Academic Medical Centre, Departments of Obstetrics and Gynaecology, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands; Academic Medical Centre, Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
| | - Susanne R de Rooij
- Academic Medical Centre, Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
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Abstract
BACKGROUND Psychosocial stress during pregnancy has been proposed as a major contributor of glucocorticoid-mediated programming of the fetal hypothalamic-pituitary adrenal (HPA) axis, with later adverse health consequences. However, evidence linking maternal stress to maternal cortisol values during pregnancy is inconclusive. A possible explanation for this is that other maternal factors overshadow any potential effects of stress on cortisol levels. We studied a large cohort of pregnant women with extensive data on pregnancy characteristics to determine the respective contributions of biological, environmental and psychosocial stress factors to cortisol levels in pregnancy. METHODS We used data from 3039 women from the Amsterdam Born Children and their Development-study cohort. Serum cortisol was measured in blood, collected at the first prenatal visit, at different gestational ages (median=91days, range=40-256days), and at various time points during the day (median=11:45h, range=08:00-18:30h). We assessed associations between maternal serum cortisol in pregnancy and biological factors, lifestyle factors and stress factors, including depression, anxiety, pregnancy-related anxiety, work stress, parenting stress and fatigue. RESULTS In multivariable analysis, variables that were associated with higher cortisol levels in pregnancy were lower maternal age [1.5nmol/l, 95%CI (0.6-2.4)], being nulliparous [21.5 nmol/l (15.9-27.1)], lower pre-pregnancy body mass index (BMI) [1.3nmol/l (0.3-2.4)], higher C-reactive protein (CRP) [1.0nmol/l (0.4-1.5)], carrying a female fetus [9.2nmol/l (1.8-16.5)], non-smoking [14.2nmol/l (0.6-27.7)], sufficient sleep [8.5nmol/l (0.9-16.1)], and being unemployed [12.7nmol/l (2.2-23.2)]. None of the psychosocial stressors was significantly associated with serum cortisol levels in pregnancy. A total of 32% of all variance in cortisol was explained by gestational age, maternal age, time of day, parity, pre-pregnancy BMI, CRP, fetal sex, smoking behavior, self-reported sleep sufficiency, and employment. CONCLUSIONS Our data suggest that maternal cortisol during pregnancy is mainly affected by biological and lifestyle factors, but not by psychosocial factors. We suggest that psychosocial stress in pregnancy might program the fetus through other mechanisms than through altering maternal cortisol levels.
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Affiliation(s)
- Laura S Bleker
- Academic Medical Centre, Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam, The Netherlands,.
| | - Tessa J Roseboom
- Academic Medical Centre, Department of Obstetrics Gynecology, Amsterdam, The Netherlands,; Academic Medical Centre, Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam, The Netherlands
| | - Tanja G Vrijkotte
- Academic Medical Centre, Amsterdam Public Health research institute, Department of Public Health, Amsterdam, The Netherlands
| | - Rebecca M Reynolds
- University/BHF Centre for Cardiovascular Science, University of Edinburgh, United Kingdom
| | - Susanne R de Rooij
- Academic Medical Centre, Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam, The Netherlands,; Academic Medical Centre, Amsterdam Public Health research institute, Department of Public Health, Amsterdam, The Netherlands
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Bleker LS, de Rooij SR, Painter RC, van der Velde N, Roseboom TJ. Prenatal Undernutrition and Physical Function and Frailty at the Age of 68 Years: The Dutch Famine Birth Cohort Study. J Gerontol A Biol Sci Med Sci 2016; 71:1306-14. [PMID: 27146370 DOI: 10.1093/gerona/glw081] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Accepted: 04/14/2016] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND There is evidence suggesting that the aging process has its origins in utero. We have previously shown that prenatal exposure to the Dutch famine is associated with chronic noncommunicable diseases and poorer cognitive function in men and women and increased mortality in women. We investigated whether prenatal undernutrition during early gestation is associated with decreased physical function in later life. METHODS Between November 2012 and September 2013, we have studied a random subsample of 150 members of the Dutch famine birth cohort at the age of 68 years, of which 49 were exposed to prenatal undernutrition. In this observational study, we measured indicators of physical function including grip strength and the short physical performance battery. We composed categories of frailty, according to the Fried frailty scale. We also assessed self-reported activity and self-perceived health. RESULTS Men, but not women, exposed to prenatal undernutrition had significantly lower grip strength (B = -4.2kg; 95% confidence interval: -8.2 to -0.3) and a lower physical performance score (B = -0.8 points; 95% confidence interval: -1.5 to 0.0) than unexposed men, independent of relevant confounders. There were no differences in frailty, self-reported activity, or self-perceived health between exposed and unexposed groups. CONCLUSIONS Our study results suggest that prenatal undernutrition is associated with decreased physical function in later life in men, but not in women. Our findings provide further evidence for the hypothesis that prenatal undernutrition may lead to an accelerated aging process in humans. We currently do not have sufficient power to detect effects on frailty.
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Affiliation(s)
- Laura S Bleker
- Clinical Epidemiology, Biostatistics and Bioinformatics,
| | | | | | - Nathalie van der Velde
- Internal Medicine, Section of Geriatrics, Academic Medical Centre, University of Amsterdam, the Netherlands
| | - Tessa J Roseboom
- Clinical Epidemiology, Biostatistics and Bioinformatics, Department of Obstetrics, Department of Gynaecology, and
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