Tags

Type your tag names separated by a space and hit enter

Independent and additive association of prenatal famine exposure and intermediary life conditions with adult mortality between age 18-63 years.

Abstract

OBJECTIVES

To quantify the relation between prenatal famine exposure and adult mortality, taking into account mediating effects of intermediary life conditions.

DESIGN

Historical follow-up study.

SETTING

The Dutch famine (Hunger Winter) of 1944-1945 which occurred towards the end of WWII in occupied Netherlands.

STUDY POPULATION

From 408,015 Dutch male births born 1944-1947, examined for military service at age 18, we selected for follow-up all men born at the time of the famine in six affected cities in the Western Netherlands (n=25,283), and a sample of unexposed time (n=10,667) and place (n=9087) controls. These men were traced and followed for mortality through the national population and death record systems.

OUTCOME MEASURE

All-cause mortality between ages 18 and 63 years using Cox proportional hazards models adjusted for intermediary life conditions.

RESULTS

An increase in mortality was seen after famine exposure in early gestation (HR 1.12; 95% confidence interval (CI): 1.01-1.24) but not late gestation (HR 1.04; 95% CI: 0.96-1.13). Among intermediary life conditions at age 18 years, educational level was inversely associated with mortality and mortality was elevated in men with fathers with manual versus non-manual occupations (HR 1.08; CI: 1.02-1.16) and in men who were declared unfit for military service (HR 1.44; CI: 1.31-1.58). Associations of intermediate factors with mortality were independent of famine exposure in early life and associations between prenatal famine exposure and adult mortality were independent of social class and education at age 18.

CONCLUSIONS

Timing of exposure in relation to the stage of pregnancy may be of critical importance for later health outcomes independent of intermediary life conditions.

Links

  • PMC Free PDF
  • PMC Free Full Text
  • Publisher Full Text
  • Authors+Show Affiliations

    ,

    Netherlands Interdisciplinary Demographic Institute NIDI, PO Box 11650, 2502 AR The Hague, Netherlands. Electronic address: ekamper@nidi.nl.

    ,

    Netherlands Interdisciplinary Demographic Institute NIDI, PO Box 11650, 2502 AR The Hague, Netherlands; Department of Sociology, Utrecht University, PO Box 80140, 3508 TC Utrecht, Netherlands. Electronic address: poppel@nidi.nl.

    ,

    Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Atlanta, GA 30322, USA. Electronic address: aryeh.stein@emory.edu.

    Mailman School of Public Health, Columbia University, 722 West 168 Street, New York, NY 10032, USA. Electronic address: lumey@columbia.edu.

    Source

    Social science & medicine (1982) 119: 2014 Oct pg 232-9

    MeSH

    Adult
    Female
    Health Status Disparities
    Humans
    Longitudinal Studies
    Male
    Middle Aged
    Mortality
    Netherlands
    Pregnancy
    Prenatal Exposure Delayed Effects
    Proportional Hazards Models
    Risk Factors
    Socioeconomic Factors
    Starvation
    World War II
    Young Adult

    Pub Type(s)

    Journal Article

    Language

    eng

    PubMed ID

    24262812

    Citation

    Ekamper, P, et al. "Independent and Additive Association of Prenatal Famine Exposure and Intermediary Life Conditions With Adult Mortality Between Age 18-63 Years." Social Science & Medicine (1982), vol. 119, 2014, pp. 232-9.
    Ekamper P, van Poppel F, Stein AD, et al. Independent and additive association of prenatal famine exposure and intermediary life conditions with adult mortality between age 18-63 years. Soc Sci Med. 2014;119:232-9.
    Ekamper, P., van Poppel, F., Stein, A. D., & Lumey, L. H. (2014). Independent and additive association of prenatal famine exposure and intermediary life conditions with adult mortality between age 18-63 years. Social Science & Medicine (1982), 119, pp. 232-9. doi:10.1016/j.socscimed.2013.10.027.
    Ekamper P, et al. Independent and Additive Association of Prenatal Famine Exposure and Intermediary Life Conditions With Adult Mortality Between Age 18-63 Years. Soc Sci Med. 2014;119:232-9. PubMed PMID: 24262812.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Independent and additive association of prenatal famine exposure and intermediary life conditions with adult mortality between age 18-63 years. AU - Ekamper,P, AU - van Poppel,F, AU - Stein,A D, AU - Lumey,L H, Y1 - 2013/11/01/ PY - 2013/03/09/received PY - 2013/07/01/revised PY - 2013/10/23/accepted PY - 2013/11/23/entrez PY - 2013/11/23/pubmed PY - 2015/8/4/medline KW - Delayed effects KW - Mortality KW - Netherlands KW - Nutrition KW - Prenatal exposure KW - World war II KW - famine SP - 232 EP - 9 JF - Social science & medicine (1982) JO - Soc Sci Med VL - 119 N2 - OBJECTIVES: To quantify the relation between prenatal famine exposure and adult mortality, taking into account mediating effects of intermediary life conditions. DESIGN: Historical follow-up study. SETTING: The Dutch famine (Hunger Winter) of 1944-1945 which occurred towards the end of WWII in occupied Netherlands. STUDY POPULATION: From 408,015 Dutch male births born 1944-1947, examined for military service at age 18, we selected for follow-up all men born at the time of the famine in six affected cities in the Western Netherlands (n=25,283), and a sample of unexposed time (n=10,667) and place (n=9087) controls. These men were traced and followed for mortality through the national population and death record systems. OUTCOME MEASURE: All-cause mortality between ages 18 and 63 years using Cox proportional hazards models adjusted for intermediary life conditions. RESULTS: An increase in mortality was seen after famine exposure in early gestation (HR 1.12; 95% confidence interval (CI): 1.01-1.24) but not late gestation (HR 1.04; 95% CI: 0.96-1.13). Among intermediary life conditions at age 18 years, educational level was inversely associated with mortality and mortality was elevated in men with fathers with manual versus non-manual occupations (HR 1.08; CI: 1.02-1.16) and in men who were declared unfit for military service (HR 1.44; CI: 1.31-1.58). Associations of intermediate factors with mortality were independent of famine exposure in early life and associations between prenatal famine exposure and adult mortality were independent of social class and education at age 18. CONCLUSIONS: Timing of exposure in relation to the stage of pregnancy may be of critical importance for later health outcomes independent of intermediary life conditions. SN - 1873-5347 UR - https://www.unboundmedicine.com/medline/citation/24262812/Independent_and_additive_association_of_prenatal_famine_exposure_and_intermediary_life_conditions_with_adult_mortality_between_age_18_63_years_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0277-9536(13)00575-3 DB - PRIME DP - Unbound Medicine ER -