J Clin Pathol 53:822-828 doi:10.1136/jcp.53.11.822

Fetal origins of adult disease: epidemiology and mechanisms

  1. C D Byrne1,
  2. D I Phillips2
  1. 1University of Southampton, School of Medicine, Endocrine and Metabolism Unit, South Academic Block, Level D, Southampton General Hospital, Southampton SO16 6YD, UK
  2. 2MRC Environmental Epidemiology Unit, Medical Research Council Environmental Epidemiology Unit, University of Southampton, Southampton General Hospital
  1. Professor Byrne email: cdtb{at}
  • Accepted 13 March 2000


The past 10 years have provided unequivocal evidence that there are associations between birth size measures and future development of adult diseases, such as type 2 diabetes and coronary artery disease. Despite initial concern that bias or residual confounding in the analyses had produced these rather bizarre associations, the findings have now been reproduced in different cohorts by independent investigators from many parts of the world. The challenge for the next decade must be to discover the cellular and molecular mechanisms giving rise to these associations. If this aim is accomplished, it might be possible to devise strategies to reduce the impact of these disabling, chronic, and expensive diseases. The purpose of this review is to describe some of the relevant, important, and more recent epidemiological studies, and also to discuss potential mechanisms underpinning the associations.J Clin Pathol(J Clin Pathol 2000;53:822–828)