The Effect of In Utero Exposure to the 1918 Influenza Pandemic on Life Expectancy

• In Event: 3129 - Section on Medical Sociology Refereed Roundtables (1 hour)
  In Refereed Roundtable 60min: Table 21. Lifecourse Events and Health

Abstract

In utero exposure to maternal infection during the prenatal period may not only have an effect on infant health, it may have lasting effects on health over the life course. Infectious pandemics offer one vantage point to isolate the effects of in utero exposure to maternal infection on adult morbidity and mortality, the developmental origins of adult health and disease. According to fetal origins theory (Barker 1995), in utero exposure to nutritional deprivation and, potentially, infection increases the chances of developing chronic health conditions in adulthood. Recent evidence lends weight to this theory, with in utero exposure to the 1918 pandemic linked to increased rates of physical disability, cardiovascular problems, cancer, and metabolic disorders (Almond 2006; Almond and Mazumder 2005; Bengtsson and Helgertz 2015; Mazumder et al. 2010). In spite of the growing evidence that in utero exposure to nutritional deprivation and maternal infection impact adult morbidity, we know less about the effects on adult mortality, particularly by timing of exposure (i.e., pregnancy trimester). We address this gap by using newly available data linking (1) monthly data on city level influenza mortality with (2) U.S. census (1910, 1920, and 1940) and (3) mortality records to assess the effect of in utero exposure to the 1918 influenza pandemic on life expectancy in the United States. Our approach will enable increased specificity with regard to the trimester-specific effects of in utero exposure to infection/stress on adult mortality rates, and will allow us to compare exposure in the periods just prior to and after pregnancy. Aside from this novel contribution, by linking to the 1940s Census we are able to obtain information about adult socioeconomic attainment, which allows us to examine whether the relationship between fetal exposure and timing of death operates through socioeconomic pathways.

Authors

• Elaine Marie Hernandez, Indiana University

• Jonas Helgertz, University of Minnesota

• Florencia Torche, Stanford University

• Claire Margerison, Michigan State

• Elizabeth Marie Anderson, Indiana University