Thorax 2000;55:555-561 ( July )

Atopy, lung function, and obstructive airways disease after prenatal exposure to famine

C E Lopuhaä^a, T J Roseboom^b, C Osmond^d, D J P Barker^d, A C J Ravelli^b, O P Bleker^c, J S van der Zee^a, J H P van der Meulen^{b d}

^a Department of Pulmonology, Academic Medical Center, University of Amsterdam, The Netherlands, ^b Department of Epidemiology and Biostatistics, ^c Department of Obstetrics and Gynaecology, ^d MRC Environmental Epidemiology Unit, University of Southampton, UK

Correspondence to: Dr J H P van der Meulen, London School of Hygiene and Tropical Medicine, Department of Public Health and Policy, Health Services Research Unit, Keppel Street, London WC1E 7HT, UK email: Jan.vanderMeulen{at}lshtm.ac.uk

Received 4 November 1999; Returned to authors 6 January 2000; Revised version received 22 February 2000; Accepted for publication 20 March 2000

BACKGROUNDAssociations have been found between a large head size at birth and atopy, and between low birth weight and obstructive airways disease. A study was undertaken of people born around the time of the Dutch famine in 1944-5 to determine the effects of maternal malnutrition during specific periods of gestation on the prevalence of obstructive airways disease and atopy.
METHODSNine hundred and twelve people aged about 50, born at term between November 1943 and February 1947 in Amsterdam, were asked about their medical history. Lung function was measured in 733 and serum concentrations of total IgE and specific IgE against mite, pollen and cat were measured in 726. Those exposed in late, mid, and early gestation (exposed participants) were compared with those born before or conceived after the famine (non-exposed participants).
RESULTSExposure to famine during gestation affected neither the concentrations of total or specific IgE nor lung function values. The prevalence of obstructive airways disease was increased in people exposed to famine in mid gestation (odds ratio adjusted for sex 1.7, 95% confidence interval (CI) 1.1 to 2.6) and tended to be higher in those exposed in early gestation (odds ratio 1.5, 95% CI 0.9 to 2.6).
CONCLUSIONSThe observed increase in the prevalence of obstructive airways disease in people exposed to famine in mid and early gestation was not parallelled by effects on IgE concentrations or lung function. The link between exposure to famine in mid and early gestation and obstructive airways disease in adulthood suggests that fetal lungs can be permanently affected by nutritional challenges during periods of rapid growth.


Keywords: fetal origins of disease; atopy; obstructive airways disease; famine

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© 2000 by Thorax
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