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Intrauterine versus extrauterine influences on adult disease risk: epidemiological aspects and sociocultural issues
  1. Ghattu V Krishnaveni1,
  2. Kalyanaraman Kumaran1,2
  1. 1 Epidemiology Research Unit, CSI Holdsworth Memorial Hospital, Mysore, Karnataka, India
  2. 2 MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
  1. Correspondence to Dr Ghattu V Krishnaveni, Epidemiology Research Unit, CSI Holdsworth Memorial Hospital, P.O. Box 38, Mandi Mohalla, Mysore 570021, Karnataka, India; gv.krishnaveni{at}gmail.com

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Traditionally, the Indian society has predefined roles for mothers as guardians of the health and well-being of their families, especially their offspring. Though outwardly flattering, this has often led to the common societal perception that mothers are responsible for all health-related issues in their children. It is ironic that recent advances in non-communicable disease (NCD) research provide evidence that a mother's role is crucial in determining the health of her progeny. In this context, the paper by Corsi et al 1 prompts one to reflect on some important epidemiological as well as social issues that relate to the intergenerational transmission of disease risk in the global perspective.

Since the inception of the developmental origins hypothesis as one of the explanations for the sudden rise in the prevalence of type 2 diabetes and other NCDs, especially in low-income and middle-income countries such as India,2 the number of studies exploring the role of maternal intrauterine environment on offspring NCD risk has increased greatly. While the influence of intrauterine factors on fetal development and future health is generally accepted, its long-term implications for adult disease are yet to be fully understood. The relationship is particularly prone to confounding as individuals are exposed during their lifecourse to a host of lifestyle and environmental factors that may be more directly and strongly related to disease occurrence. These factors themselves may be determined by the physical environment and population-specific sociocultural practices, which are likely to change often in the long interval between birth and the onset …

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