Blood pressure in adults after prenatal exposure to famine

Background Many studies have shown that low birth weight is associated with high blood pressure. The composition of the diet of pregnant women has als o been found to affect blood pressure in their children. We assessed the ef fect of prenatal exposure to the Dutch famine of 1944-1945, during which th e caloric intake from protein, fat and carbohydrate was proportionally redu ced, on blood pressures in adults now aged about 50 years. Methods and results We measured blood pressures at home and in the clinic a mong people born at term in one hospital in Amsterdam, The Netherlands, bet ween November 1 1943 and February 28 1947, for whom we had detailed birth r ecords. Blood pressures of people exposed to famine during late (n = 120), mid- (n = 109) or early gestation (n = 68) were compared with those of peop le born in the year before or conceived in the year after the famine (unexp osed subjects, n = 442). No effect of prenatal exposure on systolic and dia stolic blood pressure was observed. The mean systolic blood pressure taken in the clinic in those exposed in late gestation, and adjusted for sex and age, was 1.3 mmHg higher than in the unexposed group (95% confidence interv al -1.9 to 4.4). The mean systolic blood pressure differed by -0.6 mmHg (95 % confidence interval -3.9 to 2.7) for those exposed in mid-gestation and - 1.7 mmHg (95% confidence interval - 5.6 to 2.2) for those exposed in early gestation. People who were small at birth had higher blood pressures. A 1 k g increase in birth weight was associated with a decrease of 2.7 mmHg (95% confidence interval 0.3 to 5.1) in systolic blood pressure. Analyses of blo od pressures measured at home gave similar results. Conclusion High blood pressure was not linked to prenatal exposure to a bal anced reduction of macronutrients in the maternal diet However, it was link ed to reduced fetal growth. We postulate that it might be the composition r ather than the quantity of a pregnant woman's diet that affects her child's blood pressure in later life. J Hypertens 1999, 17:325-330 (C) Lippincott Williams & Wilkins.