In utero exposure to the Great Chinese Famine and risk of intracerebral hemorrhage in midlife

饥荒 子宫内 医学 危险系数 比例危险模型 脑出血 混淆 队列研究 置信区间 儿科 内科学 怀孕 胎儿 生物 政治学 蛛网膜下腔出血 法学 遗传学
作者
Yun Li,Yanping Li,M. Edip Gurol,Yesong Liu,Yang Peng,Jihong Shi,Sheng Zhuang,Michele R. Forman,Shouling Wu,Xiang Gao
出处
期刊:Neurology [Lippincott Williams & Wilkins]
卷期号:94 (19) 被引量:26
标识
DOI:10.1212/wnl.0000000000009407
摘要

Objective

To investigate whether in utero exposure to the Great Chinese Famine in 1959 to 1961 was associated with risk of intracerebral hemorrhage (ICH) in adulthood.

Methods

In this cohort analysis, we included 97,399 participants of the Kailuan Study who were free of cardiovascular disease and cancer at baseline (2006). Cases of incident ICH were confirmed by medical record review. We used the Cox proportional hazards model to calculate the hazard ratio (HR) and 95% confidence interval (CI) for ICH according to in utero famine exposure status.

Results

Among 97,399 participants in the current analyses, 6.3% (n = 6,160) had been prenatally exposed to the Great Chinese Famine. During a median 9.0 years of follow-up (2006–2015), we identified 724 cases of incident ICH. After adjustment for potential confounders, the HR of ICH was 1.99 (95% CI 1.39–2.85) for in utero famine-exposed individuals vs individuals who were not exposed to the famine. When exposure to famine and severity of famine were examined jointly, the adjusted HR was 2.99 (95% CI 1.21–7.39) for in utero exposure to severe famine and 1.94 (95% CI 1.32–2.84) for in utero exposure to less severe famine relative to those without exposure to famine.

Conclusions

Individuals with in utero exposure to famine, especially those exposed to severe famine, were more likely to have ICH in midlife, highlighting the role of nutritional factors in susceptibility to this severe cerebral condition.

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