MRC Integrative Epidemiology Unit, University of Bristol, Bristol Dental School, University of Bristol, United Kingdom.
MRC Integrative Epidemiology Unit, University of Bristol, Population Health Science, Bristol Medical School, University of Bristol, United Kingdom.
Soc Sci Med. 2018 Sep;213:20-27. doi: 10.1016/j.socscimed.2018.07.035. Epub 2018 Jul 21.
Research on the developmental origins of health and disease (DOHaD) has traditionally focused on how maternal exposures around the time of pregnancy might influence offspring health and risk of disease. We acknowledge that for some exposures this is likely to be correct, but argue that the focus on maternal pregnancy effects also reflects implicit and deeply-held assumptions that 1) causal early life exposures are primarily transmitted via maternal traits or exposures, 2) maternal exposures around the time of pregnancy and early infancy are particularly important, and 3) other factors, such as paternal factors and postnatal exposures in later life, have relatively little impact in comparison. These implicit assumptions about the "causal primacy" of maternal pregnancy effects set the agenda for DOHaD research and, through a looping effect, are reinforced rather than tested. We propose practical strategies to redress this imbalance through maintaining a critical perspective about these assumptions.
健康与疾病的发育起源（DOHaD）研究传统上集中于母体在妊娠前后的暴露如何影响后代的健康和疾病风险。我们承认，对于某些暴露情况来说，这可能是正确的，但我们认为，对母体妊娠影响的关注也反映了隐含的、根深蒂固的假设，即 1）因果性早期生活暴露主要通过母体特征或暴露来传递，2）妊娠和婴儿早期的母体暴露特别重要，以及 3）与这些暴露相比，其他因素（如父体因素和后期生活中的产后暴露）的影响相对较小。这些关于母体妊娠影响的“因果优先性”的隐含假设为 DOHaD 研究设定了议程，并通过循环效应得到加强而不是检验。我们通过对这些假设保持批判性观点，提出了纠正这种不平衡的实际策略。
