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Prenatal Undernutrition and Autonomic Function in Adulthood
Susanne R de Rooij1, Alexander Jones, David I Phillips
1Department of Clinical Epidemiology (de Rooij, Roseboom), Biostatistics and Bioinformatics, Academic Medical Center at the University of Amsterdam, Amsterdam, the Netherlands; Centre for Cardiovascular Imaging (Jones), UCL Institute of Cardiovascular Science, London, UK; MRC Lifecourse Epidemiology Unit (Phillips, Osmond), University of Southampton, Southampton, UK; Department of Systems Physiology (Karemaker), Heart Failure Research Center, Academic Medical Center at the University of Amsterdam, Amsterdam, the Netherlands; and Department of Obstetrics and Gynaecology (Roseboom, Painter), Academic Medical Center at the University of Amsterdam, Amsterdam, the Netherlands.
Insights
Prenatal undernutrition did not alter autonomic nervous system function in adulthood. This suggests that changes in autonomic function do not explain the increased heart disease risk observed in individuals exposed to famine during pregnancy.
Area of Science:
- Cardiovascular research
- Developmental origins of health and disease
Background:
- Early-life adversity, including prenatal undernutrition, is linked to later-life cardiovascular disease.
- The mechanisms underlying this association, particularly concerning the autonomic nervous system, remain unclear.
Purpose of the Study:
- To investigate whether prenatal undernutrition leads to alterations in autonomic nervous system function in late adulthood.
- To determine if autonomic nervous system dysfunction mediates the increased risk of heart disease associated with prenatal famine exposure.
Main Methods:
- A cohort study of 740 individuals from the Dutch famine birth cohort, assessing autonomic function.
- Participants were categorized based on exposure to famine during early, mid, or late gestation.
- Autonomic function was assessed at rest and during psychological stress (Stroop, mirror tracing, speech tasks) via continuous blood pressure and heart rate monitoring.
Main Results:
- Autonomic function indices were derived from spectral analysis in 602 participants.
- Psychological stressors induced significant changes in blood pressure, heart rate, and cardiovascular control measures.
- No significant differences in autonomic function parameters were found between prenatal famine-exposed and unexposed groups, either at rest or during stress.
Conclusions:
- Prenatal undernutrition is not associated with altered autonomic nervous system function in late adulthood.
- The study concludes that altered autonomic function does not appear to explain the previously observed increased risk of coronary heart disease in individuals exposed to prenatal famine.
Objectives:
Early-life adversity has been shown to be associated with cardiovascular disease and mortality in later life, but little is known about the mechanisms that underlie this association. Prenatal undernutrition, a severe early-life stressor, is associated with double the risk of coronary heart disease and increased blood pressure responses to psychological stress. In the present study, we tested the hypothesis that prenatal undernutrition induces alterations in the autonomic nervous system, which may increase the risk of developing heart disease.
Methods:
We studied autonomic function in 740 men and women (mean [SD] age, 58 [0.9] years) who were members of the Dutch famine birth cohort. We compared those exposed to famine during early (n = 64), mid (n = 107), or late gestation (n = 127) to those unexposed to famine in utero (n = 442). Participants underwent a series of 3 psychological stressors (Stroop, mirror tracing, and speech) while their blood pressure and heart rate were recorded continuously.
Results:
Data had sufficient quality in 602 participants for derivation of autonomic function indices by spectral analysis. The stress protocol led to significant sample-level changes in systolic blood pressure, heart rate, and all cardiovascular control measures (all p values < .001). None of the autonomic function parameters, at rest or in response to stress, differed significantly (all p values > .050) according to prenatal famine exposure.
Conclusions:
Prenatal undernutrition was not associated with autonomic function in late adulthood. We conclude that altered autonomic function does not seem to explain our previous findings of increased coronary heart disease risk among those exposed to famine prenatally.
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