Epigenetics in healthy women and babies : short and medium term maternal and neonatal outcomes

In a 1990 article in the British Medical Journal entitled ‘The fetal and infant origins of adult disease; the womb may be more important than the home’, British epidemiologist David Barker set out his hypothesis linking early life events with risk for chronic diseases.1 He based it on studies linking birth weight and infant mortality with an elevated risk for cardiometabolic diseases in adults, and cited evidence that neurodevelopmental and neurodegenerative diseases also fitted his model. Barker also recommended that research should be directed towards the intrauterine environment rather than the environments in later childhood and adulthood. Although his advice has been largely unheeded, Barker’s hypothesis has evolved into the phenomenon known as the developmental origins of health and disease (DOHaD) and has since gained mainstream acceptance. This chapter discusses the growing evidence on the epigenetic origins of disease, and then outlines the developing hypothesis that the processes of physiological labour and birth might be epigenetic triggers for positive health for the offspring, in the short, medium and longer term.