Research
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Research into maternal and foetal effects on adult health The Holdsworth memorial hospital centre for research into maternal and foetal effects on adult health, was started in the year 1993 in collaboration with the medical research council (MRC), environmental epidemiology unit (EEU), Southampton, UK. Background Studies in the UK have emphasised that factors affecting foetal and infant growth have long- lasting effects and play an important role in the pathogenesis of adult diseases, such as coronary heart diseases, stroke, diabetes and hypertension. This led to the fetal origins hypothesis (or Barker hypothesis), that adult diseases are programmed in utero by sub optimal nutrition during critical period of organogenesis. This permanently changes the body's physiology and metabolism. Consistent with the hypothesis, studies have also shown that poor maternal physique and nutrition are associated with adult disese in the offspring. The MRC EEU UK started research at HMH Mysore in order to explore these associations in developing countries like India where malnutrition is still prevalent and where there is a high incidence of low birthweight. Mortality and morbidity from coronary heart disease and diabetes have risen in recent years, and constitute a major public health problem in India. HMH was chosen for this research because of its birth records, which are unique in India. They record the birth weight, length and head circumference of all the babies born in the hospital since 1934. Many people born in HMH are still living in and around Mysore. The birth records, which span over 60 years, provide an opportunity for the centre to trace two or more generations of subjects and link them to their size at their birth. Many men and women,boys and girls, have been kind enough to take part in research studies, where we have measured their blood pressure, glucose/insulin concentration and aspects of cardiovascular function. Staff
In addition two UK-based research fellows have worked here, Dr Claudia Stein and Dr Jacqui Hill. The centre is visited regularly by Professor David Barker (Director), Dr Caroline Fall (Epidemiologist), Miss Sam Kellingary (Statistician), and Miss Vanessa Cox (System Analyst) from the MRC EEU, Southampton, UK. For more information, visit www.mrc.soton.ac.uk Achievements of the centre: Study 1 Relation of fetal growth to coronary heart disease, type 2 Diabetes mellitus and lung function. 1993-1995 * Small size at birth and low maternal weight predicted increased coronary heart disease ( Lancet 1996: 384: 1269- 1273) * Rates of type 2 diabetes mellitus were increased in those with short birthlength, or a high ponderal index at birth, and in those whose mothers were heavier with larger pelvic diameters. Low birth weight was associated with increased insulin resistance. (Diabetic Medicine 1998; 15:220-227) * Low birth weight was associated with reduced lung function in later life. ( Thorax 1997;52:895-899). Study 2 Relation of fetal growth to hypertension, left ventricular mass and arterial compliance 1995-1997. * Hypertension and left ventricular hypertrophy were associated with longer birth length but showed no relationship to low birth weight. (accepted for publication by Heart). Study 3 An intergenerational study of coronary heart disease and risk factors. 1997-1999. * Data collection is complete, and the results are being analysed. Study 4 Gestational glucose intolerance; relation to maternal and neonatal body composition 1997-1998. * Data collection is complete, and the results are being analysed. ON-GOING STUDIES AND FUTURE PLANS * Intergenerational effects on blood pressure in children aged 5-9 years. * Relation of maternal gestational diabetes to childhood growth, and the development of glucose/Insulin metabolism; follow-up of babies born in Study 4. |