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Can the gap in Aboriginal outcomes be explained by DOHaD

Part of: DOHaD in Indigenous Populations

Published online by Cambridge University Press:  06 February 2019

E. C. McEwen ,
T. J. Boulton  and
R. Smith
E. C. McEwen
Affiliation:
School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia Mothers and Babies Research Center, Priority Center in Reproduction, Hunter Medical Research Institute, University of Newcastle, Newcastle, NSW, Australia
T. J. Boulton
Affiliation:
School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia
R. Smith
Affiliation:
School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia Mothers and Babies Research Center, Priority Center in Reproduction, Hunter Medical Research Institute, University of Newcastle, Newcastle, NSW, Australia
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Abstract

In Australia, there are two distinct populations, each with vastly disparate health outcomes: Aboriginal and Torres Strait Islander People and non-Aboriginal Australians. Aboriginal Australians have significantly higher rates of health and socioeconomic disadvantage, and Aboriginal babies are also more likely to be born low birth weight or growth restricted. The Developmental Origins of Health and Disease (DOHaD) hypothesis advocates that a sub-optimal intrauterine environment, often manifested as diminished foetal growth, during critical periods of foetal development has the potential to alter the risk of non-communicable disease in the offspring. A better understanding of the role of the intrauterine environment and subsequent developmental programming, in response to both transgenerational and immediate stimuli, in Aboriginal Australians remains a relatively unexplored field and may provide insights into the prevailing health disparities between Aboriginal and non-Aboriginal children. This narrative review explores the role of DOHaD in explaining the ongoing disadvantage experienced by Aboriginal People in today’s society through a detailed discussion of the literature on the association between foetal growth, as a proxy for the quality of the intrauterine environment, and outcomes in the offspring including perinatal health, early life development and childhood education. The literature largely supports this hypothesis and this review therefore has potential implications for policy makers not only in Australia but also in other countries that have minority and Indigenous populations who suffer disproportionate disadvantage such as the United States, Canada and New Zealand.

Keywords

AboriginalAEDCbirth weightDOHaD, educationdevelopmentepigeneticsfoetal growthIndigenousNAPLANperinatal mortalitypregnancy
Type
Review
Information
Journal of Developmental Origins of Health and Disease , Volume 10 , Special Issue 1: Themed Issue: Canada / Indigenous Populations , February 2019 , pp. 5 - 16
Copyright
© Cambridge University Press and the International Society for Developmental Origins of Health and Disease 2019. 

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