Atopy lung function and obstructive airways disease afterprenatal exposure to famine

摘要

BACKGROUND—Associations 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.
METHODS—Nine 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 733and 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).
RESULTS—Exposure 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 midgestation (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 earlygestation (odds ratio 1.5,95% CI 0.9 to 2.6).
CONCLUSIONS—Theobserved increase in the prevalence of obstructive airways disease inpeople exposed to famine in mid and early gestation was not parallelledby effects on IgE concentrations or lung function. The link betweenexposure to famine in mid and early gestation and obstructive airwaysdisease in adulthood suggests that fetal lungs can be permanentlyaffected by nutritional challenges during periods of rapid growth.