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The sex-specific effects of famine on the association between placental size and later hypertension

The sex-specific effects of famine on the association between placental size and later hypertension
The sex-specific effects of famine on the association between placental size and later hypertension
Background

People who had low birth weight are at increased risk of hypertension. This may reflect fetal programming by undernutrition. Placental size is also associated with hypertension. Maternal undernutrition during the Dutch famine reduced placental surface area. We examined whether maternal undernutrition altered the relationship between placental size and later hypertension.

Methods

Retrospective cohort study among 860 subjects born in Amsterdam during 1943–47. 216 subjects were taking anti-hypertensive medication. Birth records included placental length and breadth from which we calculated its area.

Results

Among men who were not in utero during the famine hypertension was associated with a small placental surface area due to a small placental breadth, and with an oval-shaped surface. The OR for hypertension was 0.83 (95% CI 0.70 to 1.00) for a 40 cm2 increase in surface area. Among men who were in utero during the famine hypertension was associated with a large placental surface area due to a large placental breadth, and with a round-shaped surface. The OR for hypertension was 1.34 (95% CI 0.99 to 1.80) for a 40 cm2 increase in surface area. The associations between placental size and hypertension in men who were and were not in utero during the famine were significantly different (p values for interaction = 0.008 for placental surface area, 0.001 for the breadth and 0.01 for the difference in the two diameters). Among women hypertension was not associated with placental size.

Conclusions

Our study provides the first direct evidence that changes in maternal diet during pregnancy alter the relationship between placental size and later hypertension among men but not women. We suggest that among men who were not in utero during the famine, hypertension was related to impaired implantation, whereas among men who were in utero during the famine it was related to compensatory expansion of the placental surface.
fetal programming, placenta, hypertension, dutch famine, sex differences
0143-4004
694-698
van Abeelen, A.F.
dcabdeed-19ca-4dab-b9bb-0da6afc92dc0
de Rooij, S.R.
57573889-bde7-43cf-852c-753114f99852
Osmond, Clive
2677bf85-494f-4a78-adf8-580e1b8acb81
Painter, R.C.
f223b3d4-6dc9-4e17-8e32-0bc6d104111c
Veenendaal, M.V.
90f67d51-93fc-42ff-be60-6c51091a1f81
Bossuyt, P.M.
dbdb3017-517e-4dc9-a00c-158849aa2143
Elias, S.G.
db03811a-42fb-4d40-86a7-20d2862f58ae
Grobbee, D.E.
ff0f59a6-0d8b-4d7e-9e1d-3839722c8a25
van der Schouw, Y.T.
163cfe94-e2d1-438b-8000-767fa51c12f1
Barker, D.J.P.
64c6005a-eea7-4c26-8f07-50d875998512
Roseboom, T.J.
9f4c3a8a-3fb2-4c59-a539-7a7cc22d175b
van Abeelen, A.F.
dcabdeed-19ca-4dab-b9bb-0da6afc92dc0
de Rooij, S.R.
57573889-bde7-43cf-852c-753114f99852
Osmond, Clive
2677bf85-494f-4a78-adf8-580e1b8acb81
Painter, R.C.
f223b3d4-6dc9-4e17-8e32-0bc6d104111c
Veenendaal, M.V.
90f67d51-93fc-42ff-be60-6c51091a1f81
Bossuyt, P.M.
dbdb3017-517e-4dc9-a00c-158849aa2143
Elias, S.G.
db03811a-42fb-4d40-86a7-20d2862f58ae
Grobbee, D.E.
ff0f59a6-0d8b-4d7e-9e1d-3839722c8a25
van der Schouw, Y.T.
163cfe94-e2d1-438b-8000-767fa51c12f1
Barker, D.J.P.
64c6005a-eea7-4c26-8f07-50d875998512
Roseboom, T.J.
9f4c3a8a-3fb2-4c59-a539-7a7cc22d175b

van Abeelen, A.F., de Rooij, S.R., Osmond, Clive, Painter, R.C., Veenendaal, M.V., Bossuyt, P.M., Elias, S.G., Grobbee, D.E., van der Schouw, Y.T., Barker, D.J.P. and Roseboom, T.J. (2011) The sex-specific effects of famine on the association between placental size and later hypertension. Placenta, 32 (9), 694-698. (doi:10.1016/j.placenta.2011.06.012). (PMID:21742377)

Record type: Article

Abstract

Background

People who had low birth weight are at increased risk of hypertension. This may reflect fetal programming by undernutrition. Placental size is also associated with hypertension. Maternal undernutrition during the Dutch famine reduced placental surface area. We examined whether maternal undernutrition altered the relationship between placental size and later hypertension.

Methods

Retrospective cohort study among 860 subjects born in Amsterdam during 1943–47. 216 subjects were taking anti-hypertensive medication. Birth records included placental length and breadth from which we calculated its area.

Results

Among men who were not in utero during the famine hypertension was associated with a small placental surface area due to a small placental breadth, and with an oval-shaped surface. The OR for hypertension was 0.83 (95% CI 0.70 to 1.00) for a 40 cm2 increase in surface area. Among men who were in utero during the famine hypertension was associated with a large placental surface area due to a large placental breadth, and with a round-shaped surface. The OR for hypertension was 1.34 (95% CI 0.99 to 1.80) for a 40 cm2 increase in surface area. The associations between placental size and hypertension in men who were and were not in utero during the famine were significantly different (p values for interaction = 0.008 for placental surface area, 0.001 for the breadth and 0.01 for the difference in the two diameters). Among women hypertension was not associated with placental size.

Conclusions

Our study provides the first direct evidence that changes in maternal diet during pregnancy alter the relationship between placental size and later hypertension among men but not women. We suggest that among men who were not in utero during the famine, hypertension was related to impaired implantation, whereas among men who were in utero during the famine it was related to compensatory expansion of the placental surface.

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More information

e-pub ahead of print date: 13 July 2011
Published date: September 2011
Keywords: fetal programming, placenta, hypertension, dutch famine, sex differences
Organisations: Faculty of Medicine

Identifiers

Local EPrints ID: 205425
URI: http://eprints.soton.ac.uk/id/eprint/205425
ISSN: 0143-4004
PURE UUID: 129e7706-cec9-43ce-9ab0-d3ab5d52b3d6
ORCID for Clive Osmond: ORCID iD orcid.org/0000-0002-9054-4655

Catalogue record

Date deposited: 07 Dec 2011 14:31
Last modified: 15 Mar 2024 02:50

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Contributors

Author: A.F. van Abeelen
Author: S.R. de Rooij
Author: Clive Osmond ORCID iD
Author: R.C. Painter
Author: M.V. Veenendaal
Author: P.M. Bossuyt
Author: S.G. Elias
Author: D.E. Grobbee
Author: Y.T. van der Schouw
Author: D.J.P. Barker
Author: T.J. Roseboom

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