It's the mother!: How assumptions about the causal primacy of maternal effects influence research on the developmental origins of health and disease.
It's the mother!: How assumptions about the causal primacy of maternal effects influence research on the developmental origins of health and disease.
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DOI：
10.1016/j.socscimed.2018.07.035
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发表时间：
2018-09
期刊：
影响因子：
--
通讯作者：
Richardson SS
中科院分区：
文献类型：
--
作者：
Sharp GC;Lawlor DA;Richardson SS
关于健康和疾病的发育起源的研究传统上侧重于母亲在怀孕期间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，这可能是正确的，但认为对母亲怀孕影响的关注也反映了隐含的和根深蒂固的假设，即1）因果性早期生活暴露主要通过母亲的特征或暴露传播，2）怀孕和婴儿早期的母亲暴露特别重要，3）其他因素，例如父亲因素和出生后在以后生活中的暴露，相比之下影响相对较小。这些关于产妇怀孕效应的“因果首要性”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。我们提出了切实可行的战略，以纠正这种不平衡，通过保持对这些假设的批判性观点。许多母亲怀孕暴露被认为会影响后代的健康。其他因素，如父亲和出生后的暴露也可能很重要。然而，母亲妊娠暴露被认为是最重要的。我们需要对这一假设保持批判性的观点。改善因果证据基础和将调查结果置于背景中将有所帮助。
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. Many maternal pregnancy exposures are assumed to affect offspring health. Other factors like paternal and postnatal exposures are also likely to be important. Nevertheless, maternal pregnancy exposures are assumed to be most important. We need to retain a critical perspective regarding this assumption. Improving the causal evidence base and contextualising findings will help.
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