{
  "abstract": "Background The Developmental Origins of Health and Disease (DOHaD) hypothesis suggests that early life environmental exposures, especially during pregnancy, can impact long-term health. Research has largely focused on maternal factors, with less attention given to paternal, postnatal, and broader social determinants. This focus, combined with reliance on correlational evidence, could complicate efforts to determine the most effective strategies for improving population health.Methods Using harmonised data across four longitudinal cohort studies, we took a systematic approach to explore associations of prenatal health behaviours (smoking, alcohol, and caffeine consumption) at up to nine timepoints and low socioeconomic position (SEP), in both mothers and their partners, with 69 child health-related outcomes (e.g. outcomes related to body size and composition, cognitive function, mental health, blood pressure, allergy, etc) at up to four ages. Where possible, cohort estimates were meta-analysed, yielding a maximum sample size of over 256,000. We triangulated evidence of causality across analyses with genetic risk scores (Mendelian randomization), maternal-vs-paternal and during-vs-post-pregnancy negative controls, and examining dose-response. This comprehensive set of analyses generated more than 570,000 effect estimates. We developed a web app, EPoCH Explorer (https://gcsharp.shinyapps.io/EPoCH/), to visualise and share our results in an accessible format.Results We did not find strong evidence for widespread or large effects of parental health behaviors on child health and wellbeing. Only 6% of analyses had a Cohen’s D>0.2 and FDR-adjusted P<0.05. In most analyses, the effect estimate was similar for mothers and partners, with 51% showing a larger effect for mothers and 49% for partners. Despite the lack of widespread associations, we found consistent evidence for parental smoking affecting a few offspring outcomes: partner smoking was linked to higher social communication difficulties, while maternal smoking was associated with small for gestational age, higher childhood BMI, depressive symptoms, and behavioural issues. Overall, we found stronger evidence of child outcomes being associated with low SEP than with health behaviors: 15% of results for low SEP had D>0.2 and FDR-P<0.05, compared to 6% for parental smoking, 3% for alcohol, and 0.4% for caffeine.Conclusion Our findings support calls for the DoHAD field to expand the traditional focus on maternal pregnancy effects. Our study also suggests that interventions to improve population health may be most effective if they target wider social inequalities that correlate with socially-patterned parental health behaviours. We encourage researchers to use EPoCH Explorer to prioritise associations for exploration in their own datasets, thus enabling replication and cross-context comparison to validate and extend the generalisability of our findings.",
  "authors": [
    {
      "affiliations": [
        "School of Psychology, University of Exeter, Exeter, UK"
      ],
      "name": "Gemma Sharp"
    },
    {
      "affiliations": [
        "MRC Integrative Epidemiology Unit, Population Health Sciences, University of Bristol, Bristol, UK"
      ],
      "name": "Deborah Lawlor"
    },
    {
      "affiliations": [
        "School of Psychological Science, University of Bristol, Bristol, UK"
      ],
      "name": "Kayleigh Easey"
    },
    {
      "affiliations": [
        "School of Psychology, University of Exeter, Exeter, UK",
        "MRC Integrative Epidemiology Unit, Population Health Sciences, University of Bristol, Bristol, UK"
      ],
      "name": "Ahmed Elhakeem"
    },
    {
      "affiliations": [
        "Bradford Institute for Health Research, Bradford Teaching Hospitals National Health Service Foundation Trust, Bradford, UK"
      ],
      "name": "Rosie McEachan"
    },
    {
      "affiliations": [
        "Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway"
      ],
      "name": "Maria Magnus"
    },
    {
      "affiliations": [
        "Nic Waals Institute, Lovisenberg Diaconal Hospital, Oslo, Norway",
        "PROMENTA Research Centre, Department of Psychology, University of Oslo, Oslo, Norway",
        "PsychGen Centre for Genetic Epidemiology and Mental Health, Norwegian Institute of Public Health, Oslo, Norway"
      ],
      "name": "Alexandra Havdahl"
    },
    {
      "affiliations": [
        "Executive Board, London School of Hygiene and Tropical Medicine, London, UK"
      ],
      "name": "Caroline Relton"
    }
  ],
  "title": "OP75 Exploring evidence for parental prenatal influences on child health: a multicohort study and interactive data visualisation tool",
  "uid": "feab1f5e-4c69-5c71-989d-19990c6df80f"
}