INCREASED RISK OF AFFECTIVE-DISORDERS IN MALES AFTER 2ND-TRIMESTER PRENATAL EXPOSURE TO THE DUTCH-HUNGER-WINTER OF 1944-45

Background. Prenatal and perinatal factors have been linked to affecti ve disorders. We therefore undertook an exploratory study to determine whether prenatal exposure to severe famine was associated with an inc reased risk of affective disorders. Method. Monthly birth cohorts that were exposed and unexposed to the Dutch Hunger Winter of 1944-45 were identified. The cumulative incidences of affective psychoses and neur otic depression (ICD-9 criteria) were compared between exposed and une xposed cohorts during each trimester of gestation. Results. The relati ve risk (RR) of affective psychosis (broad and restricted definitions) among persons exposed to famine during the second trimester was signi ficantly increased (broad: RR (95% confidence interval)=1.62 (1.19, 2. 20); restricted: 1.59(1.14, 2.21)). Separate analysis by gender showed a significant association among males (broad: 2.26 (1.43, 3.57); rest ricted: 2.40(1.49, 3.89)), but not females (broad: 1.28(0.84, 1.94); r estricted: 1.17(0.73, 1.86)). The risk of neurotic depression was not increased after prenatal famine exposure. Conclusions. These results s uggest a possible relationship between prenatal famine during the seco nd trimester and affective psychosis, lending plausibility to reports that have associated affective psychoses with prenatal exposures. Furt her studies of this relationship are warranted.