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Childhood exposure to the 1944-1945 Dutch famine and subsequent female reproductive function
Sjoerd G Elias1, Paulus A H van Noord, Petra H M Peeters
1Julius Center for Health Sciences and Primary Care, University Medical Center, GA Utrecht, The Netherlands. s.eliase@jc.azu.nl
Background:
Childhood caloric restriction may lead to permanent changes in the hypothalamo-pituitary-gonadal axis, which could lead to impaired female reproductive ability. We assessed the effect of childhood exposure to the 1944-1945 Dutch famine on subsequent female reproductive function.
Methods:
This was a population-based cohort study in Utrecht, The Netherlands. Between 1983 and 1985, 6030 women born between 1932-1941 were classified by questionnaire according to their famine exposure experiences. Dates of marriage, first and second childbirth, and information on a medical reason for having no children or fewer children than wanted were available from questionnaires, as well as ages and type of menopause.
Results:
Severe famine exposure during childhood significantly decreased chances of first and second childbirth at any given time after marriage or first childbirth [adjusted hazard ratios (HR) 0.86, 95% confidence interval (CI) 0.76-0.96; and HR 0.87, 95% CI 0.78-0.97, respectively). Risk of a medical reason for having no or fewer children than wanted was increased in the severely exposed (odds ratio 1.88; 95% CI 1.29-2.74), as was the risk of a surgical menopause (HR 1.53; 95% CI 1.27-1.84).
Conclusions:
Our findings support the presence of longstanding modest effects of childhood famine exposure on reproductive function in women.
