Cardiac Disease in Offspring Linked to Maternal Malnutrition in Early Gestation

The first evidence to link maternal malnutrition during early gestation with the development of coronary heart disease in offspring is reported by Dutch researchers in the December issue of Heart.

Dr. Tessa J. Roseboom, of the University of Amsterdam, and colleagues collected data on children born during the Dutch famine of 1944-45. The researchers compared the prevalence of coronary heart disease in 120 subjects who were exposed to famine in late gestation with 108 subjects exposed during midgestation and with 68 subjects who were exposed during early gestation. They also evaluated 440 individuals born a year after the famine.

“Prenatal undernutrition had permanent effects on cardiovascular risk factors, Dr. Roseboom told Reuters Health. “We found that people who were exposed to the famine in early gestation had an increased risk of coronary heart disease in later life.”

The prevalence of coronary heart disease in those exposed to famine during early gestation was 8.8% compared with 3.2% for those not exposed. However, the investigators observed no increase in the prevalence of coronary heart disease in subjects exposed to famine during middle and late gestation, compared with the nonexposed group.

Although individuals with coronary heart disease tended to have lower birthweights and smaller head circumferences at birth, Dr. Roseboom’s group found the relationship between early exposure to famine and coronary heart disease to be independent of birthweight.

These findings suggest “that we may be able to prevent coronary heart disease by optimizing maternal diet during pregnancy,” she concluded. “Pregnant women are very eager to change their lifestyle for the sake of their babies, so it may be a very efficient way of preventing coronary heart disease in future generations.”

Heart 2000;84:595-598.