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Curr Epidemiol Rep. 2018 Sep;5(3):293-302. doi: 10.1007/s40471-018-0161-0. Epub 2018 Jul 13.

Developmental Origins of Disease: Emerging Prenatal Risk Factors and Future Disease Risk.

Aris IM1,2,3, Fleisch AF4,5, Oken E1,6.

Author information

Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts, USA.
Department of Obstetrics and Gynecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore, Singapore.
Pediatric Endocrinology and Diabetes, Maine Medical Center, Portland, ME, USA.
Center for Outcomes Research and Evaluation, Maine Medical Center Research Institute, Portland, ME, USA.
Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.


Purpose of review:

Many of the diseases and dysfunctions described in the paradigm of the developmental origins of health and disease have been studied in relation to prenatal nutrition or environmental toxicant exposures. Here, we selectively review the current research on four exposures-two nutritional and two environmental-that have recently emerged as prenatal risk factors for long-term health outcomes.

Recent findings:

Recent studies have provided strong evidence that prenatal exposure to (1) excessive intake of sugar-sweetened beverages, (2) unhealthy dietary patterns, (3) perfluoroalkyl substances, and (4) fine particulate matter, may increase risk of adverse health outcomes, such as obesity, cardiometabolic dysfunction, and allergy/asthma.


Emerging prenatal nutritional factors and environmental toxicants influence offspring long-term health. More work is needed to identify the role of paternal exposures and maternal exposures during the preconception period and to further elucidate causality through intervention studies. The ubiquity of these emerging nutritional and environmental exposures makes this area of inquiry of considerable public health importance.


developmental origins of disease; dietary patterns; fine particulate matter pollution; perfluoroalkyl substances; prenatal risk factors; sugar-sweetened beverages

[Available on 2019-09-01]

Conflict of interest statement

Conflict of Interest Izzuddin M Aris and Abby F. Fleisch declare no conflicts of interest; Emily Oken reports grants from US National Institutes of Health, during the conduct of the study.

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