Maternal Exposure to the Dutch Famine Before Conception and During Pregnancy: Quality of Life and Depressive Symptoms in Adult Offspring
Open accessAbstract
BACKGROUND: Gestational exposure to famine has been associated with several chronic diseases in adulthood, but few studies in humans have related prenatal famine exposure to health-related quality of life. We used the circumstances of the Dutch Famine of 1944-1945 (during which official rations were <900 kcal/day for 24 weeks) to assess whether exposure to famine prior to conception or at specified stages of pregnancy was related to self-reported health-related quality of life and depressive symptoms in adulthood. METHODS: We studied 923 individuals, including persons born in western Holland between January 1945 and March 1946, persons born in the same 3 institutions in 1943 and 1947 and same-sex siblings of persons in series 1 or 2. Between 2003 and 2005 (mean age: 59 years), we assessed self-reported quality of life with the Short Form 36 questionnaire and derived mental and physical component scores. Depressive symptoms were assessed with the Center for Epidemiologic Studies Depression scale. RESULTS: Mean mental and physical component scores were 52.4 (SD = 9.4) and 48.9 (9.0), respectively. The mean depression score was 11.6 (7.4). Age-, sex-, and schooling-adjusted estimates for mutually adjusted exposures were -2.48 for the mental component score with exposure before conception (95% confidence interval = -4.46 to -0.50) and 0.07 with exposure during pregnancy (-1.15 to 1.29). Adjusted estimates for the physical component score were 1.26 with exposure before conception (-0.67 to 3.19) and -0.73 with exposure during pregnancy (-1.94 to 0.48). Adjusted estimates for the depression score were 2.07 with exposure before conception (0.60 to 3.54) and 0.96 with exposure during pregnancy (0.09 to 1.88). There was no evidence of heterogeneity of effects by specific periods of pregnancy exposed to famine. CONCLUSIONS: A mother's exposure to famine prior to conception of her offspring was associated with lower self-reported measures of mental health and quality of life in her adult offspring.
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Prenatal famine exposure corresponds with long-term variation in cognitive and emotional regulation consistent with altered neural and glucocorticoid signaling pathways.
“Prenatal famine exposure corresponds with long-term variation in cognitive and emotional regulation consistent with altered neural and glucocorticoid signaling pathways (69, 70).”
From Epigenetic changes associated with multi-generational trauma: characterization, mechanisms, and therapeutics (2026) · cites this paper as [70]
The Discussion (page not provided) reports higher depression scores after prenatal famine exposure and poorer adult mental-health scores after preconceptional exposure. These findings support a long-term association with emotional health, but the paper does not establish variation in cognition or emotional regulation, or link the findings to altered neural or glucocorticoid signaling pathways. (LLM, conf=0.86)
Experimental — accuracy not yet measuredIn famine-exposed populations, chronic undernutrition has been associated with alterations in neurodevelopmental and stress-regulatory systems.
“In famine-exposed populations, chronic undernutrition has been associated with alterations in neurodevelopmental and stress-regulatory systems.”
From Epigenetic changes associated with multi-generational trauma: characterization, mechanisms, and therapeutics (2026) · cites this paper as [70]
The Introduction and Discussion associate maternal exposure to the Dutch famine around conception or during pregnancy with outcomes relevant to neurodevelopment, including schizophrenia, reduced intracranial volume, and congenital central nervous system abnormalities. The paper does not report alterations in stress-regulatory systems, so that part of the claim is unsupported. (LLM, conf=0.84)
Experimental — accuracy not yet measured
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- Authors
- Stein, A. D., Pierik, F. H., Verrips, G. H. W., Susser, E. S., & Lumey, L. H.
- Affiliations
- Emory University (US)
- Netherlands Organisation for Applied Scientific Research (NL)
- New York State Psychiatric Institute (US)
- Columbia University (US)
- Corresponding author
- Lumey, L H.
- Venue
- Epidemiology
- Published
- 2009-11
- Volume
- 20
- Issue
- 6
- Pages
- 909-915
- ISSN
- 1044-3983 (ISSN-L)
- PMC
- PMC3850290
- OpenAlex
- W1966866532
- Cited by
- 103
- References
- 29
- Citations by year
- 2026: 7 · 2025: 5 · 2024: 3 · 2023: 3 · 2022: 5 · 2021: 8 · 2020: 6 · 2019: 10 · 2018: 8 · 2017: 4 · 2016: 6 · 2015: 7 · 2014: 8 · 2013: 6 · 2012: 5
- FWCI
- 5.04
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Locations
- Epidemiology (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- TNO Repository (submittedVersion)
- Repository hosted by TU Delft Library (TU Delft) (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Funders
- National Heart, Lung, and Blood Institute (R01HL067914)
- Topics
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Birth, Development, and Health
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Prenatal Substance Exposure Effects
- Keywords
- Dutch famine, prenatal famine exposure, health-related quality of life, depressive symptoms, mental health, physical health, adult offspring
- MeSH terms
- Depression, Female, Fertilization, Humans, Male, Middle Aged, Netherlands, Pregnancy, Quality of Life, Surveys and Questionnaires, Starvation, Maternal Exposure, Adult Children, History, 20th Century
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