Review of the Evidence on Fetal and Early Childhood Antecedents of Adult Chronic Disease

Interest in childhood antecedents of adult disease has been fueled by recent reports suggesting that various chronic diseases of adults have their origins in fetal and infant life (1-49). Although studies proposing such a link first appeared more than 50 years ago (50), interest in the subject was rekindled by Forsdahl in 1977 (51). Forsdahl's study demonstrated an ecologic association between past living conditions in Norwegian counties and their current rates of mortality from arteriosclerotic heart disease. More recent work has emanated mostly from the Environmental Epidemiology Unit at the University of Southampton, England (1-41). Evidence from these studies suggests that fetal and early childhood growth (as reflected by birth weight, weight at age 1 year, etc.) causally determines the occurrence of such adult chronic diseases as coronary heart disease, stroke, hypertension, diabetes mellitus, chronic obstructive lung disease, ovarian cancer, suicide, autoimmune thyroiditis, abdominal obesity, atopy, diminished renal functional reserve, and predisposition to progressive renal failure in a variety of renal diseases.