Table 1 Effects of prenatal exposure to famine on mental disorders/symptoms in offspring
References | Cohort | Sample description of groups with prenatal, non-prenatal or non-exposure | Assessment of symptoms of psychopathology | Main results |
|---|---|---|---|---|
Zhou et al. [42] | Chinese Famine*a | Prenatal exposure N = 1575, ♀ not stated, mean age 50 | CES-D | Increased depressive symptoms after prenatal exposure and non-prenatal exposure compared to non-exposure*** |
Non-prenatal exposure N = 9138, ♀ not stated, age 57–69 | ||||
Non-exposure N = 1968, ♀ not stated, mean age 47 | ||||
He et al. [43] | Chinese Famine*a | Prenatal exposure N = 76, ♀ = 48, mean age not stated | GDS | Increased risk of depression after prenatal exposure compared to non-prenatal exposure* |
Non-prenatal exposure N = 80, ♀ = 28, mean age not stated | ||||
Franzek et al. [57] | Dutch Famine*b | Prenatal exposure N = 5549 | Case records of individuals with addictive behaviors in the database of the Dutch mental health care organizations | Increased risk of addictive behaviors after prenatal exposure during 1st trim (in men)*** and 3rd trim (in women)*** compared to non-exposure |
1st trim = 1738, ♀ = 812 | ||||
2nd trim = 568, ♀ = 287 | ||||
3rd trim = 3243, ♀ = 1608 | ||||
Non-exposure N = 11,630, ♀ = 5676 | ||||
Age not stated | ||||
van den Broek et al. [38] | Dutch Famine*b | Prenatal exposure N = 23, ♀ = 11 | MHI-5 | Poorer mental health after prenatal exposure compared to non-prenatal exposure** and non-exposure* |
Non-prenatal exposure N = 41, ♀ = 19 | ||||
Non-exposure N = 83, ♀ = 34 | ||||
Mean age of entire sample 57 | ||||
Franke et al. [45] | Dutch Famine*b | Prenatal exposure N = 41, ♀ = 22, mean age 67 | HADS-A/-D | No significant differences between prenatal exposure, non-prenatal exposure and non-exposure in anxiety and depressive symptoms |
Non-prenatal exposure N = 35, ♀ = 21, mean age 69 | ||||
Non-exposure N = 42, ♀ = 23, mean age 67 | ||||
He et al. [50] | Chinese Famine*a | Rural population N = 239,055, ♀ = 119,217, mean age not stated | Diagnosis of schizophrenia with ICD-10 semi-structured symptom checklist for mental disorders | Only in rural population, increased risk of schizophrenia after prenatal exposure compared to non-exposure* |
Urban population N = 148,038, ♀ = 73,471, mean age not stated | ||||
N for prenatal exposure, non-prenatal exposure and non-exposure not stated | ||||
Li et al. [40] | Chinese Famine*a | Prenatal exposure N = 996 | CES-D | More depressive symptoms after prenatal exposure during 1st and 2nd trim compared to non-exposure* |
Non-exposure N = 356 | ||||
Trim and ♀ not stated | ||||
Age of entire sample > 45 | ||||
Li et al. [39] | Chinese Famine*a | Prenatal exposure N = 1847, ♀ = 1019 | CES-D | Only in women, more depressive symptoms after prenatal exposure compared to non-exposure (significant, but p not stated) |
Non-exposure N = 2698, ♀ = 1671 | ||||
Age of entire sample > 45 | ||||
Wang et al. [47] | Chinese Famine*a | Prenatal exposure N = 81,279, ♀ = 40,509 | Diagnosis of schizophrenia with ICD-10 semi-structured symptom checklist for mental disorders | Increased risk of schizophrenia after prenatal exposure compared to non-prenatal exposure*** and non-exposure*** |
Non-prenatal exposure N = 120,287, ♀ = 59,650 | ||||
Non-exposure N = 150,429, ♀ = 75,470 | ||||
Age not stated | ||||
Huang et al. [46] | Chinese Famine*a | Prenatal exposure N = 1477, ♀ = 752 | GHQ-12 and the presence (yes/no) of eight additional risk factors for mental disorders | In women, increased GHQ-12 scores** and risk of mental disorders** and in men, decreased GHQ-12 scores** after prenatal exposure compared to non-exposure |
Non-exposure N = 1029, ♀ = 514 | ||||
Age not stated | ||||
de Rooij et al. [44] | Dutch Famine*b | Prenatal exposure N = 334 | HADS-A/-D | Only in men, higher HADS-D and HADS-A scores after prenatal exposure during 1st trim compared to non-prenatal exposure* and non-exposure* |
1st trim = 75, ♀ = 44, mean age 58 | ||||
2nd trim = 121, ♀ = 76, mean age 58 | ||||
3rd trim = 138, ♀ = 77, mean age 59 | ||||
Non-prenatal exposure N = 253, ♀ = 136, mean age 59 | ||||
Non-exposure N = 232, ♀ = 117, mean age 57 | ||||
Song et al. [51] | Chinese Famine*a | Prenatal exposure N = 81,318, ♀ = 40,415 | Diagnosis of schizophrenia based on CCMD with a semi- structured interview | Increased risk of developing schizophrenia after non-exposure compared to prenatal exposure* |
Non-prenatal exposure N = 102,068, ♀ = 50,422 | ||||
Non-exposure N = 110,970, ♀ = 56,706 | ||||
Age of entire sample 22–32 | ||||
Stein et al. [41] | Dutch Famine*b | Prenatal exposure N = 411, mean age 59 | CES-D | Increased depressive symptoms after periconceptional and prenatal exposure compared to time and sibling controls (significant, but p not stated) |
Periconceptional exposure N = 91 | ||||
Time controls N = 218, mean age 59 | ||||
Sibling controls N = 294, mean age 57 | ||||
♀ not stated | ||||
Xu et al. [36] | Chinese Famine*a | Prenatal exposure N = 126,579 | Case records (1971–2001) of schizophrenia patients from Longquanshan hospital | Increased risk of schizophrenia after prenatal exposure compared to non-prenatal exposure*** and non-exposure*** |
Non-prenatal exposure N = 329,189 | ||||
Non-exposure N = 494,684 | ||||
Age and ♀ not stated | ||||
Franzek et al. [56] | Dutch Famine*b | Prenatal exposure N = 2202, ♀ = 1055 | Case records of addictive disorder patients in the database of the Dutch mental health care organization | Increased risk of addictive disorders, especially in men*, after prenatal exposure during 1st trim compared to non-exposure** |
Non-exposure N = 5441, ♀ = 2753 | ||||
Age not stated | ||||
St. Clair et al. [35] | Chinese Famine*a | Prenatal exposure N = 141,713 | Case records (1971–2001) of schizophrenia patients from Fourth People’s hospital | Increased risk of schizophrenia after prenatal exposure compared to non-prenatal exposure*** and non-exposure*** |
Non-prenatal exposure N = 176,335 | ||||
Non-exposure N = 243,647 | ||||
Age and ♀ not stated | ||||
Brown et al. [52]c | Dutch Famine*b | Prenatal exposure N = 41,969 | Case records of patients with major affective disorder from the Dutch national psychiatric registry from 1970 to 1996 | Increased risk of major affective disorder requiring hospitalization after prenatal exposure during 2nd***and 3rd trim** for men and during 3rd trim* for women compared to non-exposure |
1st trim = 9656, ♀ = 4672 | ||||
2nd trim = 14,645, ♀ = 7185 | ||||
3rd trim = 17,668, ♀ = 8727 | ||||
Non-exposure N = 115,877, ♀ = 56,472 | ||||
Age of entire sample ≥ 18 | ||||
Neugebauer et al. [54] | Dutch Famine*b | Severe prenatal exposure N = 14,310 | Non-standardized diagnosis of ASPD in men at time of medical examination for military induction | Increased risk of ASPD after severe prenatal exposure during 1st and/ or 2nd trim compared to non-prenatal and non-exposure (significant, but p not stated) |
1st and/or 2nd trim = 9252, 3rd trim = 5058 | ||||
Non-prenatal and non-exposure N = 45,007 | ||||
Age of entire sample ≥ 18, ♀ not stated | ||||
Hoek et al. [55] | Dutch Famine*b | Prenatal exposure (Aug-Oct 1945) N = 2610 | Diagnosis of schizoid personality disorder in men with ICD-6 and ICD-9 | Increased risk of schizoid personality disorder after prenatal exposure (Oct-Dec) compared to non-prenatal and non-exposure* |
Prenatal exposure (Oct-Dec 1945) N = 2056 | ||||
Non-prenatal and non-exposure N = 64,265 | ||||
Age of entire sample > 18, ♀ not stated | ||||
Susser et al. [48]c | Dutch Famine*b | Conception at peak N = 4190, ♀ = 2006 | Case records of patients with schizophrenia from the Dutch national psychiatric registry from 1970 to 1992 | Only for conception at peak of famine, increased risk of schizophrenia compared to non-prenatal and non-exposure** |
Conception not at peak N = 5466, ♀ = 2666 | ||||
Non-prenatal and non-exposure N = 136,691, ♀ = 66,748 | ||||
Age of entire sample 24–48 | ||||
Brown et al. [53]c | Dutch Famine*b | Prenatal exposure N = 41,969 | Case records of patients with major affective disorders from the Dutch national psychiatric registry from 1978 to 1991 | Only in men, increased risk of major affective disorders after prenatal exposure during 2nd trim compared to non-prenatal and non-exposure* |
1st trim = 9656, ♀ = 4672 | ||||
2nd trim = 14,645, ♀ = 7185 | ||||
3rd trim = 17,668, ♀ = 8727 | ||||
Non-prenatal and non-exposure N = 397,052 | ||||
1st trim = 136,691, ♀ = 66,748 | ||||
2nd trim = 131,702, ♀ = 64,235 | ||||
3rd trim = 128,659, ♀ = 62,693 | ||||
Age of entire sample 32–47 | ||||
Susser et al. [49]c | Dutch Famine*b | Prenatal exposure 1st trim = 9656, ♀ = 4672 | Case records of patients with schizophrenia from the Dutch national psychiatric registry from 1978 to 1989 | Only in women, increased risk of schizophrenia after prenatal exposure during 1st trim compared to non-prenatal and non-exposure (significant, but p not stated) |
Non-prenatal and non-exposure N = 116,934, ♀ = 57,034 | ||||
Age of entire sample ≥ 19 |