How do prenatal and postnatal circumstances interact in shaping health? An interdisciplinary approach using quasi-experiments

产前和产后环境如何相互作用来塑造健康？

• 批准号: 455841434
• 负责人: Professor Dr. Reyn van Ewijk
• 金额: --
• 依托单位: Lehrstuhl für Statistik und Ökonometrie
• 依托单位国家: 德国
• 项目类别: Research Grants
• 资助国家: 德国
• 项目状态: 未结题
• 来源: https://gepris.dfg.de/gepris/projekt/455841434?language=en
• 关键词: How; do; prenatal; postnatal; circumstances

There are strong reasons to expect that prenatal and postnatal circumstances interact in shaping health, but this has hardly been studied in humans. We develop a framework for studying such effects and rigorously test this in a series of studies on specific prenatal/postnatal interactions. Our research combines medicine/epidemiology with an econometric-statistical approach.The prenatal phase is known to have long-run implications on health. Fetal programming theory describes how exposures to environmental circumstances during critical developmental phases set off adaptations that result in permanent changes to an organism’s physiology. Research on humans has focused on a wide range of adverse circumstances such as famines, pollution and toxic substances, stress, and non-famine nutritional deficits and showed negative long-run health effects.Animal studies demonstrate that organisms adapt physiologically not only in response to adverse circumstances. I.e. prenatally, organisms have a certain phenotypic plasticity that allows them to adapt to their environment, e.g. via epigenetic changes. This can be beneficial when prenatal circumstances serve as correct predictions for postnatal environments. In this sense, such Predictive Adaptive Responses (PARs) allow a species to quickly adapt to variations in circumstances it may be confronted with. If the environment encountered during gestation however differs strongly from the postnatal environment encountered by the offspring, PARs may have harmful effects.Human early-life effects studies usually focused on how adverse prenatal circumstances lead to adverse later-life health outcomes, generally ignoring potential interactions with postnatal circumstances. This may be due to the impossibility to do experiments on humans: researchers solved this by utilizing clearly demarcated, relatively short – clearly adverse – historical periods, such as famines. Such circumstances were unlikely to be followed by similar circumstances later in life, so that sufficed to establish that the prenatal environment caused long-run health damage, without a need to study whether it makes a difference whether pre- and postnatal circumstances match or mismatch.Our project is an interdisciplinary cooperation between an applied econometrician, who is specialized in the application of natural/quasi experiments in the health domain, and an epidemiologist/medical researcher, who have already been working together successfully. We will study prenatal/postnatal interactions using observational data by combining natural experiments that lead to quasi-random variation in prenatal circumstances with natural experiments that lead to quasi-random variation in postnatal circumstances. We include five research projects, that together provide a solid test of our research framework. We will use these projects to demonstrate whether and how prenatal/postnatal interactions shape human health, and to accordingly further refine this framework.

有充分的理由相信，产前和产后环境在塑造健康方面相互作用，但这几乎没有在人类中进行过研究。我们开发了一个框架来研究这种影响，并在一系列关于特定产前/产后相互作用的研究中严格测试。我们的研究将医学/流行病学与计量经济学统计方法相结合。众所周知，产前阶段对健康有长期影响。胎儿编程理论描述了在关键发育阶段暴露于环境环境如何引发适应，导致生物体生理学的永久变化。对人类的研究集中在各种各样的不利环境上，如饥荒、污染和有毒物质、压力和非饥荒的营养不足，并显示出对健康的长期不利影响。也就是说，在产前，生物体具有一定的表型可塑性，使它们能够适应环境，例如通过表观遗传变化。这可能是有益的，当产前环境作为正确的预测产后环境。从这个意义上说，这种预测适应性反应（PAR）允许物种快速适应它可能面临的环境变化。然而，如果妊娠期间遇到的环境与后代出生后遇到的环境有很大的不同，PAR可能会产生有害影响。人类早期生命影响的研究通常集中在不利的产前环境如何导致不利的晚年健康结果，通常忽略了与出生后环境的潜在相互作用。这可能是由于不可能在人类身上做实验：研究人员通过利用明显划分的、相对较短的--明显不利的--历史时期（如饥荒）来解决这个问题。这样的情况不太可能在以后的生活中出现类似的情况，因此足以确定产前环境造成长期健康损害，而不需要研究产前和产后环境是否匹配或不匹配是否有区别。我们的项目是一个应用计量经济学家之间的跨学科合作，他专门从事健康领域的自然/准实验的应用，和一位流行病学家/医学研究人员，他们已经成功地合作过。我们将研究产前/产后的相互作用，使用观察数据相结合的自然实验，导致准随机变化的产前情况与自然实验，导致准随机变化的产后情况。我们包括五个研究项目，共同提供了一个坚实的测试我们的研究框架。我们将利用这些项目来证明产前/产后的相互作用是否以及如何塑造人类健康，并相应地进一步完善这一框架。