Knowledge about the Developmental Origins of Health and Disease is independently associated with variation in diet quality during pregnancy

Abstract

Environmental factors affecting development through embryogenesis, pregnancy, and infancy impact health through all subsequent stages of life. Known as the Developmental Origins of Health and Disease (DOHaD) hypothesis, this concept is widely accepted among health and social scientists. However, it is unclear whether DOHaD-based ideas are reaching the general public and/or influencing behaviour. This study thus investigated whether and under what circumstances pregnant people in Canada are familiar with DOHaD, and if DOHaD familiarity relates to eating behaviour. Survey responses from pregnant people from Hamilton, Canada, were used to assess respondents' knowledge of DOHaD (hereafter, DOHaD_KNOWLEDGE ) compared with their knowledge of more general pregnancy health recommendations (Pregnancy Guideline_KNOWLEDGE ). The survey also characterized respondents' pregnancy diet quality and sociodemographic profiles. We fit two multiple, linear, mixed regression models to the data, one with DOHaD_KNOWLEDGE score as the dependent variable and the other with diet quality score as the dependent. In both models, responses were clustered by respondents' neighbourhoods. Complete, internally consistent responses were available for 330 study-eligible respondents. Relative to Pregnancy Guideline_KNOWLEDGE , respondents had lower, more variable DOHaD_KNOWLEDGE scores. Additionally, higher DOHaD_KNOWLEDGE was associated with higher socio-economic position, older age, and lower parity, independent of Pregnancy Guideline_KNOWLEDGE . Diet quality during pregnancy was positively associated with DOHaD_KNOWLEDGE , adjusting for sociodemographic factors. A subset of relatively high socio-economic position respondents was familiar with DOHaD. Greater familiarity with DOHaD was associated with better pregnancy diet quality, hinting that translating DOHaD knowledge to pregnant people may motivate improved pregnancy nutrition and thus later-life health for developing babies.

Keywords: developmental origins; diet quality; health inequities; knowledge translation; nutrition; pregnancy.

Figure 1

Frequency of responses from participants in each socio‐economic position (SEP) bracket. SEP scores of 2–4 indicate lower household income (<$23,000 per year) and low (no completed post‐secondary) respondent educational attainment levels. SEP scores of 5–7 indicate higher respondent educational attainment levels (at least some post‐secondary) and household income brackets near the city's median ($40,000–$79,000). SEP scores of 8 indicate high respondent educational attainment levels (completion of at least one post‐secondary degree) and household incomes >$80,000 per year. Seventy (21%) of respondents have SEP scores of ≤4, 127 (38%) have scores of 5–7, and 133 (40%) have SEP scores of 8.

Figure 2

Distributions of respondents' Pregnancy Guideline_KNOWLEDGE and DOHaD_KNOWLEDGE scores. Ninety‐one (27%) of respondents have Pregnancy Guideline_KNOWLEDGE scores of 16, the modal score for this variable. Forty (12%) of respondents have DOHaD_KNOWLEDGE scores of 10, the modal score for this variable

Figure 3

Scatterplot of linear relationship between DOHaD_KNOWLEDGE score and SEP score. Data are presented as individual scores of DOHaD_KNOWLEDGE and SEP. Open circles = respondents without prior pregnancies, closed circles = respondents who have one or two children, and plusses = respondents with three and more children. As SEP score increases, DOHaD_KNOWLEDGE score increases. Respondents with three and more children (plusses) are relatively likely to fall below the fit line.

Figure 4

Scatterplot of linear relationship between diet quality score and DOHaD_KNOWLEDGE score. Data are presented as individual scores of diet quality score and DOHaD_KNOWLEDGE score. Open circles = respondents without prior pregnancies, closed circles = respondents who have one or two children, and plusses = respondents with three and more children. As DOHaD_KNOWLEDGE score increases, diet quality score increases. Respondents with three and more previous children (plusses) are relatively likely to fall below the fit line.