Cardiovascular Morbidity and Mortality in Finnish Men and Women Separated Temporarily From Their Parents in Childhood—A Life Course Study
- Hanna Alastalo, MHS,
- Katri Räikkönen, PhD,
- Anu-Katriina Pesonen, PhD,
- Clive Osmond, PhD,
- David J.P. Barker, MD,
- Kati Heinonen, PhD,
- Eero Kajantie, MD, PhD and
- Johan G. Eriksson, MD, DMSc, PhD
+ Author Affiliations
From the Department of Chronic Disease Prevention (H.A., E.K., J.G.E.), National Institute for Health and Welfare; Department of Public Health (H.A.),Hjelt Institute, Institute of Behavioural Sciences (K.R., A.-K.P., K.H.), Department of General Practice and Primary Health Care (J.G.E.), University ofHelsinki; Hospital for Children and Adolescents (A.-K.P., E.K.), Unit of General Practice (J.G.E.), Helsinki University Central Hospital; Folkhälsan Research Center (J.G.E.), Helsinki; Vaasa Central Hospital (J.G.E.), Vaasa, Finland; MRC Lifecourse Epidemiology Unit (C.O.), University of Southampton; DOHaD Division (D.J.P.B.), Southampton, United Kingdom; and Oregon Health and Science University (D.J.P.B.), Portland, Oregon.
- Address correspondence and reprint requests to Hanna Alastalo, MSc, MHS, Department of Chronic Disease Prevention, National Institute for Health and Welfare, PO Box 30, FIN-00271 Helsinki, Finland. E-mail: hanna.alastalo@thl.fi
Abstract
Objective Early-life stress may influence health later in life. We examined morbidity and mortality from cardiovascular disease over 60 years in individuals separated temporarily from their parents in childhood due to World War II.
Methods We studied 12,915 members of the Helsinki Birth Cohort Study born from 1934 to 1944, of whom 1726 (13.4%) had been evacuated aboard without their parents to temporary foster families for an average of 1.8 (standard deviation = 1.1) years at an average age of 4.6 (standard deviation = 2.4) years. Data on parental separations were extracted from the Finnish National Archives. Information on use of medication for coronary heart disease and hypertension was derived from the National Register of Medication Reimbursement, and information on coronary events, stroke, and cardiovascular deaths was derived from Finnish Hospital Discharge Register and Causes of Death Register between Years 1971 and 2003.
Results Participants who were separated in childhood used medications for coronary heart disease more frequently than those who were not separated (7.2% versus 4.5%, respectively; hazard ratio [HR] = 1.29, 95% confidence interval [CI] = 1.04–1.59; p = .02). No associations between separation and all-cause mortality (HR = 1.04, 95% CI = 0.90–1.20) or cardiovascular mortality (HR = 0.94, 95% CI = 0.72–1.21) or hospitalizations for cardiovascular disease or stroke were observed.
Conclusions Early-life stress may possibly be a factor predisposing to coronary heart disease decades later, but no evidence was found for increased risk of hospitalizations or mortality.
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