Prenatal Famine Exposure and Long-Term Consequences for Anthropometry and Adult Health

  • Tessa Roseboom
  • Rebecca Painter
  • Susanne de Rooij


This paper describes the findings from a cohort study of 2,414 people born around the time of the Dutch famine. We found more coronary heart disease, a more atherogenic lipid profile, disturbed blood coagulation, and increased stress responsiveness among those exposed to famine in early gestation. Women exposed to famine in early gestation were more obese and had an increased risk of breast cancer. People exposed to famine in mid gestation had more microalbuminuria and obstructive airway disease. Exposure to famine during any stage of gestation was associated with glucose intolerance. Also, women who had been exposed to famine prenatally were more reproductively successful: they started reproducing at an earlier age, had more children, more twins, and were less likely to remain childless. The effects of prenatal famine exposure did not appear to be restricted to those exposed to it prenatally: also, their children appeared to be less healthy. These findings show that maternal undernutrition during gestation has important effects on health in later life, but that the effects on health depend on its timing during gestation. Early gestation seems to be an especially vulnerable period. Adequate dietary advice to women before and during pregnancy seems a promising strategy in preventing chronic diseases in future generations.


Prenatal Exposure Adult Health Late Gestation Early Gestation Maternal Nutrition 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. Banning C. Food shortage and public health, first half of 1945. Am Ac Polit Soc Sci, 1946;245:93–110.CrossRefGoogle Scholar
  2. Barker DJP. Fetal origins of coronary heart disease BMJ. 1995;311:171–4.Google Scholar
  3. Burger GCE, Sandstead HR, Drummond JC, edtiors. Malnutrition and starvation in Western Netherlands, September 1944 to July 1945. Part I and II. The Hague: General State Printing Office, 1948.Google Scholar
  4. Harding J. The nutritional basis of the fetal origins of adult disease Int J Epidemiol. 2001;30:15–23.PubMedCrossRefGoogle Scholar
  5. Hoek HW, Susser EZ, Buck K, Lumey LH, Lin SP, Gorman, JM. Schizoid personality disorder after prenatal exposure to famine. Am J Psych, 1996;153:1637–9.Google Scholar
  6. Hoet JJ, Hanson M. Intrauterine nutrition: its importance during critical periods for cardiovascular and endocrine development J Physiol. 1999;514:617–27.PubMedCrossRefGoogle Scholar
  7. Lopuhaä CE, Roseboom TJ, Osmond C, Barker DJP, Ravelli ACJ, Bleker OP, van der Zee JS, van der Meulen JHP. Atopy, lung function and obstructive airways disease after prenatal exposure to famine. Thorax. 2000;55:555–61.PubMedCrossRefGoogle Scholar
  8. Lumey LH. Decreased birth weight in infants after maternal in utero exposure to the Dutch famine of 1944–1945 Paed Perinat Epi. 1992;6:240–53.CrossRefGoogle Scholar
  9. Lumey LH, Stein AD, Ravelli ACJ. Timing of prenatal starvation in women and birth weight in their first and second born offspring: the Dutch famine birth cohort study. Eur J Obs Gyn. 1995;61:23–30.CrossRefGoogle Scholar
  10. Lussana F, Buller H, Bossuyt PM, Ocke M, Roseboom TJ. Prenatal exposure to the Dutch famine is associated with a preference for fatty foods and a more atherogenic lipid profile. Am J Clin Nutr. 2008;88(6):1648–52.PubMedCrossRefGoogle Scholar
  11. Murray C, Lopez A. Global mortality, disability, and the contribution of risk factors: global burden of disease study. Lancet. 1997;349:1436–42.PubMedCrossRefGoogle Scholar
  12. Neugebauer R, Hoek HW, Susser E. Prenatal exposure to wartime famine and development of antisocial personality disorder in early adulthood JAMA. 1999;282:455–62.PubMedCrossRefGoogle Scholar
  13. Painter RC, Roseboom TJ, van Montfrans GA, Bossuyt PMM, Krediet RT, Osmond C, Barker DJP, Bleker OP. Microalbuminurea in adults after prenatal exposure to the Dutch famine. J Am Soc Nephrol. 2005;16(1):189–94.PubMedCrossRefGoogle Scholar
  14. Painter RC, de Rooij SR, Bossuyt PM, Phillips DI, Osmond C, Barker DJ, Bleker OP, Roseboom OP. Blood pressure response to psychological stressors in adults after prenatal exposure to the Dutch famine. J Hypertens. 2006a;24:1771–8.PubMedCrossRefGoogle Scholar
  15. Painter RC, de Rooij SR, Roseboom TJ, Bossuyt PM, Simmers TA, Osmond C, Barker DJP, Bleker OP. Early onset of coronary artery disease after prenatal exposure to the Dutch famine Am J Clin Nutr. 2006b;84:322–7.PubMedGoogle Scholar
  16. Painter RC, de Rooij SR, Bossuyt PMM, Osmond C, Barker DJP, Bleker OP, Roseboom TJ. A possible link between prenatal exposure to famine and breast cancer – a preliminary study. Am J Hum Biol. 2006c;18:853–6.PubMedCrossRefGoogle Scholar
  17. Painter RC, Westendorp RGJ, de Rooij SR, Osmond C, Barker DJP, Roseboom TJ. Increased reproductive success after prenatal exposure to famine. Hum Reprod. 2008;23(11):2591–5.PubMedCrossRefGoogle Scholar
  18. Painter RC, Osmond C, Phillips DIW, Hanson MA, Roseboom TJ. Transgenerational effects of prenatal exposure to the Dutch famine on neonatal adiposity and health in later life BJOG. 2008;115:1243–9.PubMedCrossRefGoogle Scholar
  19. Ravelli GP, Stein ZA, Susser MW. Obesity in young men after famine exposure in utero and early pregnancy. NEJM. 1972;7:349–54.Google Scholar
  20. Ravelli ACJ, van der Meulen JHP, Michels RPJ, Osmond C, Barker DJP, Hales CN, Bleker OP. Glucose tolerance in adults after in utero exposure to the Dutch famine. Lancet. 1998;351:173–7.PubMedCrossRefGoogle Scholar
  21. Ravelli ACJ, Van der Meulen JHP, Osmond C, Barker DJP, Bleker OP. Obesity at the age of 50 y in men and women exposed to famine prenatally. Am J Clin Nutr. 1999;70:811–6.PubMedGoogle Scholar
  22. de Rooij SR, Painter RC, Roseboom TJ, Phillips DI, Osmond C, Barker DJ, Tanck MW, Michels RP, Bossuyt PM, Bleker OP. Glucose tolerance at age 58 and the decline of glucose tolerance in comparison with age 50 in people prenatally exposed to the Dutch famine. Diabetologia. 2006;49(4):637–43.PubMedCrossRefGoogle Scholar
  23. Roseboom TJ, van der Meulen JHP, Osmond C, Barker DJP, Ravelli ACJ, Bleker OP. Plasma lipid profile in adults after prenatal exposure to the Dutch famine. Am J Clin Nutr. 2000a;72:1101–6.PubMedGoogle Scholar
  24. Roseboom TJ, van der Meulen JHP, Ravelli ACJ, Osmond C, Barker DJP, Bleker OP. Plasma fibrinogen and factor VII concentrations in adults after prenatal exposure to famine Br J Haematol. 2000b;111:112–7.PubMedCrossRefGoogle Scholar
  25. Roseboom TJ, van der Meulen JHP, Osmond C, Barker DJP, Ravelli ACJ, Schroeder-Tanka JM, van Montfrans GA, Michels RPJ, Bleker OP. Coronary heart disease after prenatal exposure to the Dutch famine 1944-45. Heart. 2000c;84(6):595–8.PubMedCrossRefGoogle Scholar
  26. Smith C. The effects of wartime starvation in Holland on pregnancy and its product. Am J Obs Gyn. 1947;53:599–608.Google Scholar
  27. Stearns SC. The evolution of life histories. Oxford: Oxford University Press; 1992.Google Scholar
  28. Stein Z, Susser M, Saenger G, Marolla F. Nutrition and mental performance Science. 1972;178:706–13.Google Scholar

Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  • Tessa Roseboom
    • 1
  • Rebecca Painter
  • Susanne de Rooij
  1. 1.Department of Clinical Epidemiology Biostatistics and Bioinformatics, Department of Obstetrics and GynaecologyAcademic Medical CenterAmsterdamthe Netherlands

Personalised recommendations