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A Lifecourse Approach to Health Development: Implications for the Maternal and Child Health Research Agenda

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Abstract

Lifecourse-informed models of health fundamentally challenge simple biomedical models, introducing new ways of thinking about how diseases develop. This paper considers the broad implications of lifecourse theory for the maternal and child health (MCH) research agenda. The Lifecourse Health Development model provides an organizing framework for a synthesis of the existing literature on lifecourse health and identification of gaps in knowledge. Priority areas identified for MCH research in order to close these knowledge gaps include: epigenetic mechanisms and their potential mutability; peri-conception as a critical and sensitive period for environmental exposures; maternal health prior to pregnancy; the role of the placenta as an important regulator of the intra-uterine environment; and ways to strengthen early mother–child interactions. Addressing knowledge gaps will require an emphasis on longitudinal rather than cross-sectional studies, long-term (lifetime) rather than short-term perspectives, datasets that include socio-demographic, biologic and genetic data on the same subjects rather than discipline-specific studies, measurement and study of positive health as well as disease states, and study of multi-rather than single generational cohorts. Adoption of a lifecourse-informed MCH research agenda requires a shift in focus from single cause-single disease epidemiologic inquiry to one that addresses multiple causes and outcomes. Investigators need additional training in effective interdisciplinary collaboration, advanced research methodology and higher-level statistical modeling. Advancing a life course health development research agenda in MCH will be foundational to the nation’s long-term health.

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References

  1. Elder, G. H. (1998). The life course as developmental theory. Child Development, 69(1), 1–12.

    PubMed  Google Scholar 

  2. Smith, G. D., & Kuh, D. (2001). Commentary: William Ogilvy Kermack and the childhood origins of adult health and disease. International Journal of Epidemiology, 30(4), 696–703.

    Article  CAS  PubMed  Google Scholar 

  3. Elder, G. H., Johnson, M. K., & Crosnoe, R. (2003). The emergence and development of life course theory. In J. T. Mortimer & M. J. Shanahan (Eds.), Handbook of the life course. New York: Kluwer Academic/Plenum Publishers.

    Google Scholar 

  4. Barker, D. J., Osmond, C., Golding, J., et al. (1989). Growth in utero, blood pressure in childhood and adult life, and mortality from cardiovascular disease. British Medical Journal, 298(6673), 564–567.

    Article  CAS  PubMed  Google Scholar 

  5. Barker, D. J., Winter, P. D., Osmond, C., et al. (1989). Weight in infancy and death from ischaemic heart disease. Lancet, 2(8663), 577–580.

    Article  CAS  PubMed  Google Scholar 

  6. Barker, D. (2003). The midwife, the coincidence, and the hypothesis. British Medical Journal, 327(7429), 1428–1430.

    Article  PubMed  Google Scholar 

  7. Barker, D. J. (2007). The origins of the developmental origins theory. Journal of Internal Medicine, 261(5), 412–417.

    Article  CAS  PubMed  Google Scholar 

  8. Eriksson, J. G. (2011). Early growth and coronary heart disease and type 2 diabetes: Findings from the Helsinki Birth Cohort Study (HBCS). The American Journal of Clinical Nutrition, 94(6 Suppl), 1799S–1802S.

    Article  CAS  PubMed  Google Scholar 

  9. Osmond, C., Kajantie, E., Forsen, T. J., et al. (2007). Infant growth and stroke in adult life: The Helsinki Birth Cohort Study. Stroke, 38(2), 264–270.

    Article  PubMed  Google Scholar 

  10. Risnes, K. R., Vatten, L. J., Baker, J. L., et al. (2011). Birthweight and mortality in adulthood: A systematic review and meta-analysis. International Journal of Epidemiology, 40(3), 647–661.

    Article  PubMed  Google Scholar 

  11. Ben-Shlomo, Y., & Kuh, D. (2002). A life course approach to chronic disease epidemiology: Conceptual models, empirical challenges and interdisciplinary perspectives. International Journal of Epidemiology, 31(2), 285–293.

    Article  PubMed  Google Scholar 

  12. Gluckman, P. D., Hanson, M. A., Cooper, C., et al. (2008). Effect of in utero and early-life conditions on adult health and disease. New England Journal of Medicine, 359(1), 61–73.

    Article  CAS  PubMed  Google Scholar 

  13. Wadsworth, M. E. J. (1999). Early life. In M. Marmot & R. G. Wilkinson (Eds.), Social determinants of health (pp. 44–63). New York: Oxford Press.

    Google Scholar 

  14. Acheson, D., Barker, D., Chamber, J., et al. (1998). Report of the independent inquiry into inequalities in health (the acheson report). London: The Stationary Office.

    Google Scholar 

  15. Aylot, J., Brown, I., Copeland, R., et al. (2008). Tackling obesities: The Foresight Report and implications for local government. Sheffield, South Yorkshire: Sheffield Hallam University, Faculty of Health and Wellbeing.

    Google Scholar 

  16. Foresight Mental Capital and Wellbeing Project. (2008). Final project report—executive summary. London: The Government Office for Science.

    Google Scholar 

  17. Marmot, M. (2010). The Marmot review: Strategic review of health inequalities in England post-2010. London: The Marmot Review.

    Google Scholar 

  18. Committee on Breast Cancer and the Environment, Institute of Medicine. (2011). Breast cancer and the environment: A life course approach. Washington, DC: Institute of Medicine of the National Academy of Sciences. Available at: http://www.iom.edu/~/media/Files/Report%20Files/2011/Breast-Cancer-Environment/BreastCancerReportbrief_2.pdf.

  19. Committee on Leading Health Indicators for Healthy People 2020, Institute of Medicine. (2011). Leading health indicators for Healthy People 2020: Letter report. Washington, DC: Institute of Medicine of the National Academy of Sciences. Available at: http://www.iom.edu/~/media/Files/Report%20Files/2011/Leading-Health-Indicators-for-Healthy-People-2020/Leading%20Health%20Indicators%202011%20Report%20Brief.pdf.

  20. Hertzman, C. (1994). The lifelong impact of childhood experiences—a population health perspective. Daedalus, 123(4), 167–180.

    Google Scholar 

  21. Power, C., & Hertzman, C. (1997). Social and biological pathways linking early life and adult disease. British Medical Bulletin, 53(1), 210–221.

    Article  CAS  PubMed  Google Scholar 

  22. Hertzman, C. (1999). The biological embedding of early experience and its effects on health in adulthood. Annals New York Academy of Sciences, 896, 85–95.

    Article  CAS  Google Scholar 

  23. Halfon, N., & Hochstein, M. (2002). Life course health development: An integrated framework for developing health, policy, and research. The Milbank Quarterly, 80(3), 433–479.

    Article  PubMed Central  PubMed  Google Scholar 

  24. Lu, M. C., & Halfon, N. (2003). Racial and ethnic disparities in birth outcomes: A life-course perspective. Maternal and Child Health Journal, 7(1), 13–30.

    Article  PubMed  Google Scholar 

  25. Halfon, N., Russ, S. A., & Regalado, M. (2005). The life course health development model: A guide to children’s health care policy and practice. Zero to Three, 25(3), 4–12.

    Google Scholar 

  26. Schonkoff, J. P., Boyce, W. T., & McEwan, B. S. (2009). Neuroscience, molecular biology, and the childhood roots of health disparities: Building a new framework for health promotion and disease prevention. The Journal of the American Medical Association, 301(21), 2252–2259.

    Article  Google Scholar 

  27. Fine, A., & Kotelchuck, M. (2010). Rethinking MCH: The life course model as an organizing framework. Washington, DC: U.S. Department of Health and Human Services Health Resources and Services Administration, Maternal and Child Health Bureau. Available at: http://mchb.hrsa.gov/lifecourse/rethinkingmchlifecourse.pdf.

  28. Halfon, N., Inkelas, M., & Hochstein, M. (2000). The health development organization: An organizational approach to achieving child health development. The Milbank Quarterly, 78(3), 447–497 (341).

    Google Scholar 

  29. Institute of Medicine. (2004). Children’s health, the nation’s wealth. Washington, DC: The National Academies Press.

    Google Scholar 

  30. Hertzman, C., & Boyce, T. (2010). How experience gets under the skin to create gradients in developmental health. Annual Review of Public Health, 31, 329–347 (3p following 47).

    Google Scholar 

  31. Noble, K. G., Houston, S. M., Kan, E., et al. (2012). Neural correlates of socioeconomic status in the developing human brain. Developmental Science, 1–12.

  32. Cicchetti, D. (2011). Allostatic load. Development and Psychopathology, 23(3), 723–724.

    Article  PubMed  Google Scholar 

  33. Cicchetti, D., Rogosch, F. A., Toth, S. L., et al. (2011). Normalizing the development of cortisol regulation in maltreated infants through preventive interventions. Development and Psychopathology, 23(3), 789–800.

    Article  PubMed  Google Scholar 

  34. Kuzawa, C. W., & Thayer, Z. M. (2011). Timescales of human adaptation: The role of epigenetic processes. Epigenomics, 3(2), 221–234.

    Article  CAS  PubMed  Google Scholar 

  35. Low, F. M., Gluckman, P. D., & Hanson, M. A. (2011). Developmental plasticity and epigenetic mechanisms underpinning metabolic and cardiovascular diseases. Epigenomics, 3(3), 279–294.

    Article  CAS  PubMed  Google Scholar 

  36. Meaney, M. J. (2001). Maternal care, gene expression, and the transmission of individual differences in stress reactivity across generations. Annual Review of Neuroscience, 24, 1161–1192.

    Article  CAS  PubMed  Google Scholar 

  37. Lester, B. M., Tronick, E., Nestler, E., et al. (2011). Behavioral epigenetics. Annals of the New York Academy of Sciences, 1226, 14–33.

    Article  PubMed Central  PubMed  Google Scholar 

  38. Michels, K. B., & Waterland, M. R. (2012). The role of epigenetics in the developmental origins of health and disease. In K. B. Michels (Ed.), Epigenetic epidemiology (pp. 105–116). New York: Springer.

    Chapter  Google Scholar 

  39. Borghol, N., Suderman, M., McArdle, W., et al. (2012). Associations with early-life socio-economic position in adult DNA methylation. International Journal of Epidemiology, 41(1), 62–74.

    Article  PubMed  Google Scholar 

  40. Breslau, N. (1995). Psychiatric sequelae of low birth weight. Epidemiologic Reviews, 17(1), 96–106.

    CAS  PubMed  Google Scholar 

  41. Maccani, M. A., & Marsit, C. J. (2009). Epigenetics in the placenta. American Journal of Reproductive Immunology, 62(2), 78–89.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  42. Bromer, C., Marsit, C. J., & Armstrong, D. A., et al. (2012). Genetic and epigenetic variation of the glucocorticoid receptor (nr3c1) in placenta and infant neurobehavior. Developmental Psychobiology.

  43. Hochberg, Z., Feil, R., Constancia, M., et al. (2011). Child health, developmental plasticity, and epigenetic programming. Endocrine Reviews, 32(2), 159–224.

    Article  CAS  PubMed  Google Scholar 

  44. Gluckman, P. D., Hanson, M. A., & Buklijas, T. (2010). A conceptual framework for the developmental origins of health and disease. Journal of Developmental Origins of Health and Disease, 1(01), 6–18.

    Article  CAS  Google Scholar 

  45. Cordero, M. I., Poirier, G. L., Marquez, C., et al. (2012). Evidence for biological roots in the transgenerational transmission of intimate partner violence. Translational Psychiatry, 2, e106.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  46. Heijmans, B. T., Tobi, E. W., Lumey, L. H., et al. (2009). The epigenome: Archive of the prenatal environment. Epigenetics, 4(8), 526–531.

    Article  CAS  PubMed  Google Scholar 

  47. Reik, W., Dean, W., & Walter, J. (2001). Epigenetic reprogramming in mammalian development. Science, 293(5532), 1089–1093.

    Article  CAS  PubMed  Google Scholar 

  48. Reik, W., & Walter, J. (2001). Genomic imprinting: Parental influence on the genome. Nature Reviews Genetics, 2(1), 21–32.

    Article  CAS  PubMed  Google Scholar 

  49. Barker, D. J. P. (2002). Fetal programming of coronary heart disease. Trends in Endocrinology and Metabolism, 13(9), 364–368.

    Article  CAS  PubMed  Google Scholar 

  50. Adair, L. S., & Cole, T. J. (2003). Rapid child growth raises blood pressure in adolescent boys who were thin at birth. Hypertension, 41(3), 451–456.

    Article  CAS  PubMed  Google Scholar 

  51. Taveras, E. M., Rifas-Shiman, S. L., Belfort, M. B., et al. (2009). Weight status in the first 6 months of life and obesity at 3 years of age. Pediatrics, 123(4), 1177–1183.

    Article  PubMed Central  PubMed  Google Scholar 

  52. Gillman, M. W. (2009). Childhood prevention of hypertensive cardiovascular disease. The Journal of Pediatrics, 155(2), 159–161.

    Article  PubMed  Google Scholar 

  53. Liu, S., Jones, R. N., & Glymour, M. M. (2010). Implications of lifecourse epidemiology for research on determinants of adult disease. Public Health Review, 32(2), 489–511.

    Google Scholar 

  54. Moffitt, T. E. (2005). Genetic and environmental influences on antisocial behaviors: Evidence from behavioral-genetic research. Advances in Genetics, 55, 41–104.

    PubMed  Google Scholar 

  55. Jokela, M., Lehtimaki, T., & Keltikangas-Jarvinen, L. (2007). The influence of urban/rural residency on depressive symptoms is moderated by the serotonin receptor 2a gene. American Journal of Medical Genetics Part B, Neuropsychiatric Genetics, 144B(7), 918–922.

    Article  CAS  Google Scholar 

  56. Gilbert, S. F. (2000). Developmental biology (6th ed.). Sunderland, MA: Sinauer Associates.

    Google Scholar 

  57. Gluckman, P. D., Hanson, M. A., Bateson, P., et al. (2009). Towards a new developmental synthesis: Adaptive developmental plasticity and human disease. Lancet, 373(9675), 1654–1657.

    Article  PubMed  Google Scholar 

  58. Bateson, P., & Gluckman, P. (2012). Plasticity and robustness in development and evolution. International Journal of Epidemiology, 41(1), 219–223.

    Article  PubMed  Google Scholar 

  59. Hochberg, Z. (2011). Evolutionary perspectives in child growth. Rambam Maimonides Medical Journal, 2(3), e0057.

    Article  PubMed Central  PubMed  Google Scholar 

  60. Halfon, N., Verhoef, P. A., & Kuo, A. A. (2012). Childhood antecedents to adult cardiovascular disease. Pediatrics in Review, 33(2), 51–61.

    Article  PubMed  Google Scholar 

  61. Gottesman, I. I., & Gould, T. D. (2003). The endophenotype concept in psychiatry: Etymology and strategic intentions. The American Journal of Psychiatry, 160(4), 636–645.

    Article  PubMed  Google Scholar 

  62. Brotman, M. A., Guyer, A. E., Lawson, E. S., et al. (2008). Facial emotion labeling deficits in children and adolescents at risk for bipolar disorder. The American Journal of Psychiatry, 165(3), 385–389.

    Article  PubMed  Google Scholar 

  63. Arcaleni, E. (2006). Secular trend and regional differences in the stature of italians, 1854–1980. Economics and Human Biology, 4(1), 24–38.

    Article  PubMed  Google Scholar 

  64. Connor, N. E. (2011). Impact of fetal and neonatal malnutrition on the onset of puberty and associated noncommunicable disease risks. Adolescent Health, Medicine and Therapeutics, 2011, 15–25.

    Article  Google Scholar 

  65. Martinson, M. L. (2012). Income inequality in health at all ages: A comparison of the United States and England. American Journal of Public Health, 102(11), 2049–2056.

    Article  PubMed  Google Scholar 

  66. Wilkinson, R. G., & Pickett, K. E. (2009). The spirit level: Why equality is better for everyone. New York: Bloomsbury Press.

    Google Scholar 

  67. Siddiqi, A., Kawachi, I., Berkman, L., et al. (2007). Variation of socioeconomic gradients in children’s developmental health across advanced capitalist societies: Analysis of 22 OECD nations. International Journal of Health Services, 37(1), 63–87.

    Article  PubMed  Google Scholar 

  68. Hertzman, C., Siddiqi, A., Hertzman, E., et al. (2010). Bucking the inequality gradient through early child development. British Medical Journal, 340, c468.

    Article  PubMed  Google Scholar 

  69. Goldman, D. P., Shang, B., Bhattacharya, J., et al. (2005). Consequences of health trends and medical innovation for the future elderly. Health Affairs, 24(Suppl 2), W5R5–W5R17.

    PubMed  Google Scholar 

  70. Schadt, E. E., & Bjorkegren, J. L. (2012). New: Network-enabled wisdom in biology, medicine, and health care. Science Translational Medicine, 4(115), 115rv1.

    Article  PubMed  Google Scholar 

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Acknowledgments

The authors would like to thank Amy Graber for her assistance with manuscript preparation. This Research was supported in part by funding from HRSA-MCHB for the Lifecourse Research Network (LCRN) (cooperative agreement #UA6MC19803).

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Correspondence to Shirley A. Russ.

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Russ, S.A., Larson, K., Tullis, E. et al. A Lifecourse Approach to Health Development: Implications for the Maternal and Child Health Research Agenda. Matern Child Health J 18, 497–510 (2014). https://doi.org/10.1007/s10995-013-1284-z

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