HERTFORDSHIRE RECORDS : DOHAD

Dr. SB BhattacharyyaMBBS, MBA, FCGP

Member, EMR Standards Committee, MoH&FW, GoIMember, Health Informatics Sectional Committee, MHD 17, BIS

President (2010 – 2011), IAMIHony. State Secretary (2015), IMA Haryana

Hertfordshire Records :: DOHAD

■ Meticulous birth records were maintained throughout Hertfordshire County, UK, from 1911 to 1948 through the efforts of a dedicated and visionary midwife, Ethel Margaret Burnside

■ A health visitor subsequently went to each baby’s home throughout its infancy and recorded its illnesses, development and method of infant feeding; the baby was then weighed again at 1 year of age. This information was transcribed into ledgers at the Hertfordshire county office

■ Through linking these birth records with health in later life by a research team headed by Dr David Barker led to the development of the fetal origins hypothesis termed DOHAD (developmental origins of health and diseases)

■ http://www.mrc.soton.ac.uk/herts/downloads/

Dr SB Bhattacharyya© 2

Hertfordshire Records :: DOHAD

■ On studying these records, it was observed that a disproportionate number of the children whose records were kept had died of coronary heart disease or related disorders and most of these had occurred among people who had had low birth weight.

■ It seemed remarkable that the weights of babies measured by Miss Burnside’s simple spring balances, often in badly lit cottages and hovels, could so strongly predict events more than 50 years later.

■ These early findings raised the question of what processes are initiated in foetal and infant life and lead ultimately to disease and premature death.

■ The results of the research have more than justified all the activity.

■ The research led to DOHAD and a Nobel Prize.

Dr SB Bhattacharyya© 3

Hertfordshire records & DOHAD –Lessons Learnt

■ From just the sex and weights at birth and 1 year age, a definitive correlation could be drawn between them and development of diseases later on in life that led to a Nobel Prize (in medicine)

■ One can only wonder what all can be unearthed if more comprehensive records are available

Dr SB Bhattacharyya© 5

Dr SB Bhattacharyya© 6

Thanks!