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

Yun Li, Yanping Li, M. Edip Gurol, Yesong Liu, Peng Yang, Jihong Shi, Sheng Zhuang, Michele R. Forman, Shouling Wu, Xiang Gao

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish (US)
Pages (from-to)e1996-e2004
JournalNeurology
Volume94
Issue number19
DOIs
StatePublished - May 12 2020

All Science Journal Classification (ASJC) codes

  • Clinical Neurology

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    Li, Y., Li, Y., Gurol, M. E., Liu, Y., Yang, P., Shi, J., Zhuang, S., Forman, M. R., Wu, S., & Gao, X. (2020). In utero exposure to the Great Chinese Famine and risk of intracerebral hemorrhage in midlife. Neurology, 94(19), e1996-e2004. https://doi.org/10.1212/WNL.0000000000009407