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Early life risk and resiliency factors and their influences on developmental outcomes and disease pathways: a rapid evidence review of systematic reviews and meta-analyses

Published online by Cambridge University Press:  04 August 2020

Ayah Abdul-Hussein
Department of Health Sciences, Carleton University, Ottawa, ON, Canada
Ayesha Kareem
Department of Health Sciences, Carleton University, Ottawa, ON, Canada
Shrankhala Tewari
Department of Health Sciences, Carleton University, Ottawa, ON, Canada
Julie Bergeron
Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
Laurent Briollais
Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, ON, Canada
John R. G. Challis
University of Toronto, Toronto, ON, Canada Simon Fraser University, Burnaby, BC, Canada
Sandra T. Davidge
Women and Children’s Health Research Institute and Obstetrics and Gynaecology, University of Alberta, Edmonton, AB, Canada
Claudio Delrieux
Universidad Nacional del Sur Argentina, Bahía Blanca, Argentina
Isabel Fortier
Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
Daniel Goldowitz
Medical Genetics, University of British Columbia, Vancouver, BC, Canada
Pablo Nepomnaschy
Simon Fraser University, Burnaby, BC, Canada
Ashley Wazana
Psychiatry, McGill University, Montreal, Canada
Kristin L. Connor*
Department of Health Sciences, Carleton University, Ottawa, ON, Canada
Address for correspondence: Dr. Kristin Connor, Department of Health Sciences, Carleton University, 1125 Colonel By Drive, 3310 Health Sciences Building, Ottawa, ON, Canada. Email:


The Developmental Origins of Health and Disease (DOHaD) framework aims to understand how environmental exposures in early life shape lifecycle health. Our understanding and the ability to prevent poor health outcomes and enrich for resiliency remain limited, in part, because exposure–outcome relationships are complex and poorly defined. We, therefore, aimed to determine the major DOHaD risk and resilience factors. A systematic approach with a 3-level screening process was used to conduct our Rapid Evidence Review following the established guidelines. Scientific databases using DOHaD-related keywords were searched to capture articles between January 1, 2009 and April 19, 2019. A final total of 56 systematic reviews/meta-analyses were obtained. Studies were categorized into domains based on primary exposures and outcomes investigated. Primary summary statistics and extracted data from the studies are presented in Graphical Overview for Evidence Reviews diagrams. There was substantial heterogeneity within and between studies. While global trends showed an increase in DOHaD publications over the last decade, the majority of data reported were from high-income countries. Articles were categorized under six exposure domains: Early Life Nutrition, Maternal/Paternal Health, Maternal/Paternal Psychological Exposure, Toxicants/Environment, Social Determinants, and Others. Studies examining social determinants of health and paternal influences were underrepresented. Only 23% of the articles explored resiliency factors. We synthesized major evidence on relationships between early life exposures and developmental and health outcomes, identifying risk and resiliency factors that influence later life health. Our findings provide insight into important trends and gaps in knowledge within many exposures and outcome domains.

© Cambridge University Press and the International Society for Developmental Origins of Health and Disease 2020

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These authors contributed equally to the work


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