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Neurodevelopmental Disorders after Prenatal Famine: The Story of the Dutch Famine Study

1998; Oxford University Press; Volume: 147; Issue: 3 Linguagem: Inglês

10.1093/oxfordjournals.aje.a009439

1476-6256

E.S. Susser, Hans W. Hoek, Amy Brown,

Gestational Diabetes Research and Management

The Dutch Famine Study (1) was one of the classic epidemiologic investigations that emerged from the Columbia University School of Public Health in the 1960s.In accord with its initial aim, the study has produced precious clues as to the role of prenatal nutrition in the etiology of neurodevelopmental disorders; yet the findings and their implications have emerged piecemeal, over decades.To our knowledge, the various branches of this neurodevelopmental research have never been tied together in a single thread.This commentary is intended to fill the gap and to tell the story of the Dutch Famine Study as an early model for epidemiologic research on prenatal exposures. THE ORIGINAL DESIGNThe Dutch Famine Study was a "natural experiment" based on an extraordinary historical event known as the Dutch Hunger Winter.In 1940, the Netherlands were invaded by the German army, and by 1941 virtually all foods were being rationed.For several years, the rationing successfully ensured basic nutrition for the population, with a well-balanced average daily ration in the range of 1,500-2,000 kcal for most of the period.Toward the end of 1944, however, that situation changed.After the Allied defeat at Arnhem in September of 1944, the Nazi occupation force imposed an embargo on transport in the region still under occupation, which included the Netherlands' six largest cities: Amsterdam, Rotterdam, The Hague, Utrecht, Leiden, and Haarlem.The embargo almost immediately produced a food shortage in these cities, which over the ensuing cold winter of 1944-1945 evolved into a severe famine.