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Hum. Reprod. Advance Access originally published online on June 2, 2005
Human Reproduction 2005 20(9):2483-2488; doi:10.1093/humrep/dei090
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© The Author 2005. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions{at}oupjournals.org

Childhood exposure to the 1944–1945 Dutch famine and subsequent female reproductive function

Sjoerd G. Elias1,3, Paulus A.H. van Noord1, Petra H.M. Peeters1, Isolde den Tonkelaar2 and Diederick E. Grobbee1

1 Julius Center for Health Sciences and Primary Care, University Medical Center, PO Box 85500, 3508 GA Utrecht and 2 International Health Foundation, Europalaan 506, 3526 KS, Utrecht, The Netherlands

3 To whom correspondence should be addressed at: Julius Center for Health Sciences and Primary Care, Str. 6.119, University Medical Center Utrecht, PO Box 85060, 3508 AB Utrecht, The Netherlands. Email: s.elias{at}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.

Key words: caloric restriction/famine/human/reproduction/subfertility


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