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Hum. Reprod. Advance Access published online on June 2, 2005
Human Reproduction, 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@oupjournals.org
Received August 4, 2003
Revised November 15, 2004
Accepted April 25, 2005

Article

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

Sjoerd G. Elias 1*, Paulus A.H. van Noord 1, Petra H.M. Peeters 1, Isolde den Tonkelaar 2, and Diederick E. Grobbee 1

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

* To whom correspondence should be addressed.
Sjoerd G. Elias, E-mail: s.elias{at}jc.azu.nl


  Abstract

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.

Keywords: caloric restriction; famine; human; reproduction; subfertility.
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