The Dutch Hunger Winter Study: Malnutrition in Pregnant Woman

Due to ethics, experimentation on humans is widely looked down upon and illegal in numerous countries including the United States. There is no ethical way to actually experiment on critical human development periods that aren’t already covered by epidemiology studies. Although an unfortunate situation, this is why the Dutch Hunger Winter Study became a useful human pregnancy deprivation study without purposefully experimenting on and harming humans. After a railway strike in the winter of 1944, a paradox was noted after series of studies regarding adverse fetal environments and their effects. During the strike, the German rationed food in the Netherlands to have people, including pregnant woman, to receive 400 to 800 calories per day to people of all social class. Focusing primarily on pregnant woman, malnutrition caused at different gestation stages gave an insight on the growing field of fetal development and disease. 

The study showed that depending on the time of conception, the effects of the famine did not necessarily result in abnormal birth weight or any long lasting consequences. That early nutrition is indirectly related to fetal growth. Woman who were pregnant mid to late pregnancies during the famine gave birth to babies with reduced birth weights and were smaller with lower rates of obesity. Those exposed during early pregnancies when the strike occurred had more normal birth weights but then grew up with higher rates of obesity and cardiovascular disease.

The results from this incident showed that timing of nutrition provided to a fetus is crucial to their development and long term health. If a fetus is developing in a scarce environment, its body will adjust to develop within that scarce environment but those adjustments may show long term negative effects due to the bodies inability to perform certain functions effectively. Whereas a fetus that is developing in a rich environment and is suddenly malnutritioned will most likely be born smaller, but since majority of its development period did not require metabolic adjustments, the fetus will have better bodily functions and will overall develop into a healthier adult. 

The importance on early trimester development is that it is when the central nervous system is formed and with insufficient nutrients provided for healthy development, it causes change in the underlying mental health of the fetus, alterations in its metabolism and long term cognitive function decline. Fetal adaptations to scarcity become maladaptive when the baby is later exposed to a richer environment. The Dutch Hunger Winter lasted for a limited time and the Netherlands returned to adequate diets which the deprived fetus had already altered their body to adapt to inadequate environments. Importance of catch-up growth after adverse intrauterine conditions is a phenomenon that was better understood after the study, raising more emphasis on the importance of environmental consistency for fetal growth. 

References:

Schulz, L. C. (2010, September 28). The Dutch Hunger Winter and the developmental origins of

health and disease. Retrieved from http://www.pnas.org/content/107/39/16757