Barker's Hypothesis Among the Global Poor: Positive Long-Term Cardiovascular Effects of in Utero Famine Exposure

Demography. 2023 Dec 1;60(6):1747-1766. doi: 10.1215/00703370-11052790.

Abstract

An influential literature on the Developmental Origins of Health and Disease (DOHaD) has documented that poor conditions in utero lead to higher risk of cardiovascular disease at older ages. Evidence from low-income countries (LICs) has hitherto been missing, despite the fact that adverse in utero conditions are far more common in LICs. We find that Malawians exposed in utero to the 1949 Nyasaland famine have better cardiovascular health 70 years later. These findings highlight the potential context specificity of the DOHaD hypothesis, with in utero adversity having different health implications among aging LIC individuals who were exposed to persistent poverty.

Keywords: Barker hypothesis; Cardiovascular health; Developmental origins of health and disease; Early-life influence on later-life health; Sub-Saharan Africa.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aging
  • Cardiovascular Diseases* / epidemiology
  • Famine*
  • Female
  • Humans
  • Prenatal Exposure Delayed Effects* / epidemiology
  • Southern African People

Supplementary concepts

  • Malawian people