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Spanish Flu of 1918 Left Heart Disease Legacy Among the Unborn

ByMICHAEL SMITHMedPage Today North American Correspondent
October 01, 2009, 1:58 PM

Oct. 1, 2009— -- Male babies in the womb during the peak of the 1918-1919 flu pandemic were at increased risk of heart disease when they reached their 60s, 70s and 80s, researchers said.

In those men, the rate of heart disease was more than 23 percent higher than among those whose mothers were not pregnant during the pandemic's virulent phase in the fall of 1918, according to Dr. Caleb Finch, of the University of Southern California, and colleagues.

The main factor in the increase was a 32.7 percent rise in the rate of ischemic disease, Finch and colleagues reported online in the Journal of Developmental Origins of Health and Disease.

The 1918 pandemic was the most deadly on record, with mortality estimated as high as 100 million people worldwide.

But Finch said he and colleagues are concerned that even milder flu may have long-term consequences for the children of women pregnant during an outbreak.

"Our point is that during pregnancy, even mild sickness from flu could affect development with longer consequences," Finch said in a statement. "There is particular concern for the current swine flu, which seems to target pregnant women."

Other experts said the study appears to be solid, but cautioned against using it to draw conclusions about the current pandemic.

"I'd be extremely reluctant to infer anything about the 2009 swine flu outbreak from these findings," said Philip Alcabes of City University of New York.

Among other things, the study showed that heart disease was more common among all those who were in utero at the time, and not those whose mothers were actually infected with the flu, said Alcabes, who is the author of Dread: How Fear And Fantasy Have Fueled Epidemics From The Black Death To Avian Flu.

Since many women who were pregnant at that time either died or lost their babies, he said, "it could be that heart disease developed preferentially in offspring of women who were not infected, possibly because of some other exposure."

Dr. Howard Markel of the University of Michigan called the study "fascinating" but added that it only shows an association between later heart disease and in utero exposure.

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