Journal Article

OP75 Exploring evidence for parental prenatal influences on child health: a multicohort study and interactive data visualisation tool

Sharp, Gemma, Relton Caroline, McEachan Rosie, Elhakeem Ahmed, Magnus, Maria, Havdahl Alexandra, Easey Kayleigh, Lawlor, Deborah

2025

Overview

BackgroundThe 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.MethodsUsing 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.ResultsWe 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.ConclusionOur 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.

• Publisher: BMJ Publishing Group LTD
• Subject: Allergies / Blood pressure / Body size / Caffeine / Children / Childrens health / Cognitive ability / Genetic analysis / Genetic crosses / Gestational age / Health behavior / Mental health / Offspring / Parental behavior / Pregnancy / Small for gestational age / Smoking / Well being