n Obstetrics and Gynaecology Forum - Developmental origin of non-communicable diseases in children in the Western Cape : review

Volume 24, Issue 1
  • ISSN : 1027-9148



There is convincing evidence that many of common chronic diseases such as ischaemic heart disease (IHD), hypertension and diabetes mellitus have their origin, or at least part of it, during fetal development. The idea of the fetal origin of diseases, or the developmental origin of health and disease (DOHaD) as it is called today, originated in 1986 when Barker and Osmond, on division of the United Kingdom into different regions, observed a strong geographical relation between IHD mortality rates in 1968-78 and infant mortality in 1921-25. They further found that IHD strongly correlated with both neonatal and post neonatal mortality. As these neonatal conditions were associated with poor living circumstances, poor nutrition in early life was identified as a possible causing factor. In the follow-up of 5 654 men, born during 1911-1930, Barker et al. found that men with the lowest weights at birth and at one year had the highest death rates from IHD in later life, leading them to suggest that measures that promote healthy prenatal and postnatal growth may reduce deaths from IHD. In the follow up of 1 084 men, Law et al. found that the mean waist-to-hip ratio at 51 to 64 years was inversely related to birth weight. The same group studied 702 people born in Amsterdam during the famine of 1944-45 and found that prenatal exposure to poor nutrition, especially during late gestation, was linked to decreased glucose tolerance in adults.

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