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Early life exposure to famine and reproductive aging among Chinese women

Wang, Nengying, MD1; Huang, Yinqiong, MD1; Wen, Junping, MD1; Su, Qing, MD2; Huang, Yanling, MD1; Cai, Liangchun, MD1; Lin, Wei, MD1; Zong, Liyao, MD1; Huang, Huibin, MD1; Qian, Xiaofang, MD1; Zhu, Fengye, MD1; Sun, Han, MD1; Yao, Jin, MD1; Tang, Kaka, MD1; Chen, Ling, MD1; Liang, Jixing, MD1; Li, Liantao, MD1; Lin, Lixiang, MD1; Lu, Jieli, MD3; Bi, Yufang, MD3; Wang, Weiqing, MD3; Zheng, Yan, MD, PhD4; Chen, Gang, MD1,5

doi: 10.1097/GME.0000000000001259
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Objective: To assess the effect of early life exposure to famine, as endured during 1959 to 1961 in China, on reproductive aging in adult women.

Methods: Between 2011 and 2012, 2,868 women born around the Chinese famine period (1956-1964) were enrolled in this study from three communities in China. Age at natural menopause was obtained retrospectively from a structured questionnaire. The associations of early life famine exposure with reproductive aging during adulthood were estimated, with adjustment of socioeconomic status, lifestyle factors, and body mass index.

Results: Women exposed to prenatal famine had a higher risk of early menopause (ie, natural menopause <45 years, odds ratio: 1.59, 95% confidence interval [CI]: 1.07, 2.36), and a nonsignificant trend of higher risk of premature ovarian failure (ie, natural menopause <40 y, odds ratio: 1.94, 95% CI: 0.93, 4.00), compared to unexposed women. Exposure to famine during childhood was not significantly associated with reproductive aging. In a secondary analysis focusing on the fetal exposure, prenatal famine exposure was associated with a higher risk of premature ovarian failure (odds ratio: 2.07, 95% CI: 1.08, 3.87), and a nonsignificant trend of higher risk of early menopause (odds ratio: 1.37, 95% CI: 0.98, 1.91), compared to those unexposed to prenatal famine.

Conclusions: Our study showed that fetal exposure to famine was associated with an increased risk of early menopause. Such findings provided evidence in favor of the thrifty phenotype theory in reproductive aging and helped better understand the etiology of early menopause.

1Department of Endocrinology, Shengli Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital, Fuzhou, China

2Department of Endocrinology, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China

3Department of Endocrinology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China

4State Key Laboratory of Genetic Engineering, Human Phenome Institute and School of Life Sciences, Fudan University, Shanghai, China

5Fujian Academy of Medical Sciences, Fuzhou, China.

Address correspondence to: Gang Chen, MD, Department of Endocrinology, Shengli Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital, Fujian Academy of Medical Sciences, Fuzhou, China. E-mail: chengangfj@163.com; Yan Zheng, MD, PhD, State Key Laboratory of Genetic Engineering, Human Phenome Institute and School of Life Sciences, Fudan University, Shanghai, China. E-mail: yan_zheng@fudan.edu.cn

Received 5 June, 2018

Revised 20 September, 2018

Accepted 20 September, 2018

Nengying Wang, Yinqiong Huang, Junping Wen, and Qing Su contributed equally to this study.

Funding Sources: This study was supported by grants from the National Key New Drug Creation and Manufacturing Program of Ministry of Science and Technology (2012ZX09303006-001), Chinese Medical Association Foundation and Chinese Endocrine Society (12020240314), and the National Key New Drug Creation and Manufacturing Program of Ministry of Science and Technology (2012ZX09303006-001). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Financial disclosures/conflicts of interest: The author reports no conflicts of interest in this work.

© 2019 by The North American Menopause Society.