Effects of Prenatal exposure to famine on Adulthood Anthropometric Profile among Survivors of 1975-77 E.C. Great Ethiopian Famine ‘’Kifu Qen’’, North Wollo Zone, Northeast Ethiopia, 2019: A Historical Cohort Study

Abstract

Background: Chronic illness has become a global worsening public health problem that continues to rise each year in both developed and developing countries, irrespective of their sociodemographic index. The etiologic markers of such diseases can traced back to the developmental basis, as poor prenatal undernutrition is hypothesized to have be a greater role in later obesity and related disease. Thus, reviewing such context specific factors for chronic diseases as well as its risk factor is critical undertaking. More specifically, studying the impacts of prenatal famine exposure on adulthood anthropometric indices would have greater importance to uncover the role of early assaults on later health. Objective: This study aimed to determine the effects of prenatal exposure to famine on adulthood anthropometric profile among survivors of the 1975-77 E.C. Great Ethiopian Famine occurred in Wollo province, Northeast Ethiopia. Method: A historical cohort study design was employed from 15 March to 30 April, 2019 to compare anthropometric profile of adult survivors of The Great Ethiopian Famine with their control adult born after the Famine in selected woredas of North Wollo zone. Total of 698(96% response) subjects born from 1 April, 1975 to August 30,1977 was included as the exposed, whereas adults born from September 1,1979 to September,1981 were included as unexposed using study participants were selected using simple random sampling. Anthropometric measurements were taken using standardized procedures and relevant data were gathered using a pretested structured questionnaire. Data were coded and entered using Epi-data version 3.1 and analyzed using SPSS version 23. Independent sample t-test and chi-square test was used to compare differences among exposed and unexposed groups. Both unadjusted and adjusted Odd Ratios was estimated for the associations between prenatal famine exposure and adult overweight/obesity as well as abdominal obesity using a logistic regression model. A p-value of less than 0.05 was taken to declare the level of significance. Results: The average waist circumference of exposed adults was higher than unexposed one (2.1, 95%CI (0.4, 3.6), p=0.01). Similarly, exposed adults have shown higher waist to height ratio (0.02, 95%CI (0.01, 0.03), p=0.01). Contrarily, decreased in average height was observed among exposed adults compared to nonexposed (-2.04, 95%CI (-3.284, -0.791), p=0.001). However, nonsignificant difference was noticed while comparing BMI among two cohorts (0.385, 95%CI (- 0.188, 0.958), p= 0.187). There were also higher odds of abdominal obesity among exposed group compared to non-exposed cohort (AOR:1.425, 95%CI (1.053,1.929)), but test for association for the general obesity had shown non-significant relationship (AOR: 1.166, 95%CI (0.827, 1.643), p= 0.382)). Conclusion: Prenatal famine exposed adults were in general shorter, had more abdominal obesity and raised waist to height ratio. These finding indicates prenatal famine may have shaped the adults to assume more anthropometric risks for chronic illness, Prevention of fetal undernutrition should be given high priority to reduce the prevalence of obesity consequently minimizing risk of acquiring non-communicable diseases.