Fetal programming and the Leningrad Siege study

Area of Science:

• Cardiovascular Science
• Nutritional Epidemiology
• Developmental Origins of Health and Disease

Background:

• The Dutch Hunger Winter studies suggest prenatal famine exposure increases adult cardiovascular disease (CVD) risk.
• The Leningrad Siege provides a unique cohort for studying long-term effects of severe intrauterine starvation on CVD risk factors.

Purpose of the Study:

• To investigate the association between intrauterine starvation during the Leningrad Siege and adult risk factors for coronary heart disease.
• To compare outcomes in individuals exposed to starvation in utero versus those not exposed.

Main Methods:

• Screened 169 subjects exposed to intrauterine starvation during the Leningrad Siege (1941-4).
• Included control groups: 192 born before the siege and 188 born outside the siege area concurrently.
• Assessed glucose tolerance, insulin concentration, blood pressure, lipid profiles, coagulation factors, and endothelial dysfunction markers (von Willebrand factor).

Main Results:

• No significant differences were found in glucose tolerance, insulin, blood pressure, lipids, or coagulation factors between intrauterine-exposed and control groups.
• The intrauterine-exposed group showed higher von Willebrand factor concentrations, indicating endothelial dysfunction.
• A stronger interaction between adult obesity and blood pressure was observed in the intrauterine-exposed group.

Conclusions:

• Intrauterine starvation during the Leningrad Siege was not associated with increased adult glucose intolerance, dyslipidaemia, hypertension, or cardiovascular disease.
• Findings contrast with the Dutch Hunger Winter, suggesting famine-specific effects and highlighting the role of catch-up growth in mitigating risks.