Fetal Origins of Socioeconomic Inequalities in Early Childhood Health: the Generation R Study

The aim was to contribute to a further understanding of the origins of socioeconomic inequalities in child health, and, more in particular, of the possible role of intrauterine exposures in the genesis of these inequalities. Therefore, we studied socioeconomic inequalities, using maternal education as socioeconomic indicator, in 1) maternal health outcomes during pregnancy, 2) indicators of fetal growth, and 3) early childhood health outcomes. First, we found that women of low socioeconomic status (SES) have lower chances of completing a healthy pregnancy: they display more risk factors, such as psychosocial stress and smoking during pregnancy, and are more likely to develop preeclampsia, gestational hypertension and gestational diabetes. This may negatively affect health of the offspring. Our findings also have implications for these womenâ?Ts cardiovascular health, as they suggest an underlying increased cardiovascular risk that is manifested during pregnancy. Second, we found that fetal and early postnatal health is affected by motherâ?Ts socioeconomic status. Offspring of women of low SES grow more slowly in utero, grow faster in height during early childhood, and are more susceptible to upper respiratory tract infections compared with offspring of women of high SES. Last, we found some evidence for a contribution of intrauterine exposures to the explanation of socioeconomic inequalities in height and linear growth, and upper respiratory tract infections in early childhood, although this contribution was relatively limited. Future research may shed more light on the contribution of intrauterine exposures to socioeconomic inequalities in other early childhood health outcomes, as well as in inequalities in child health at later ages.

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