Decreased birthweights in infants after maternal <i>in utero</i> exposure to the Dutch famine of 1944–1945

Using maternity records of the University of Amsterdam teaching hospital for births 1960-1984, obstetric outcomes in 1808 first-born singleton offspring of mothers born between 1 January 1944 and 30 June 1946 in The Netherlands were analysed. Most of these mothers had experienced, during intra-uterine life, a war-induced famine that lasted from November 1944 to May 1945. The study was prompted by a report on increased perinatal mortality in offspring of such mothers and it aimed at describing late effects, if any, of such an exposure. Mothers exposed to famine during their first and second trimester in utero had offspring with birthweights lower than mothers not exposed to famine. The decrease in birthweight was in part due to slower fetal growth rate, in part to shorter gestation. Birthweights in the offspring of mothers exposed in their third trimester in utero were, however, not reduced. These findings in mothers exposed to famine in utero are in contrast to the effects of the famine on their mothers during their pregnancies, where third trimester exposure was associated with a reduction in birthweight. The effect of in utero exposure on birthweight persisted after control for potential confounding and intervening variables. Paradoxically, similar effects were seen in offspring of some mothers presumably not exposed to malnutrition. In this study, clear effects on reproductive outcomes are seen in the generation following an environmental exposure in utero.