Abstract
The “fetal origins” hypothesis suggests that fetal conditions not only affect birth characteristics such as birth weight and gestational age, but also have lifelong health implications. Despite widespread interest in this hypothesis, few methodological advances have been proposed to improve the measurement and modeling of fetal conditions. A Statistics in Medicine paper by Bollen, Noble, and Adair examined favorable fetal growth conditions (FFGC) as a latent variable. Their study of Filipino children from Cebu provided evidence consistent with treating FFGC as a latent variable that largely mediates the effects of mother’s characteristics on birth weight, birth length, and gestational age. This innovative method may have widespread utility, but only if the model applies equally well across diverse settings. Our study assesses whether the FFGC model of Cebu replicates and generalizes to a very different population of children from North Carolina (N = 705) and Pennsylvania (N = 494). Using a series of structural equation models, we find that key features of the Cebu analysis replicate and generalize while we also highlight differences between these studies. Our results support treating fetal conditions as a latent variable when researchers test the fetal origins hypothesis. In addition to contributing to the substantive literature on measuring fetal conditions, we also discuss the meaning and challenges involved in replicating prior research.
Highlights
Few hypotheses have received more attention than Barker’s fetal origins hypothesis [1], both within the current journal [2, 3] and in the fields of medicine and social science more broadly [4]
Based on this series of tests, we conclude that the results first gleaned from a sample of Filipino infants do generalize to a sample of predominantly low-income American infants
The final model, including all modifications, fit the data well in the two states that we tested (North Carolina and Pennsylvania), which suggests that these findings may be robust to variations in sampling characteristics
Summary
Few hypotheses have received more attention than Barker’s fetal origins hypothesis [1], both within the current journal [2, 3] and in the fields of medicine and social science more broadly [4]. Much of the existing work is focused on replicating Barker’s original finding that birth weight is inversely related to adult risk of cardiovascular disease, using different populations, different health outcomes, or both. Almost all studies of which we are aware use birth weight as a proxy variable for fetal growth conditions. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript
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