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A lifecourse approach to health development: Implications for the maternal and child health research agenda

机译：一种生命发展方法，对健康发展的影响：对母婴健康研究议程的影响

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Lifecourse-informed models of health fundamentally challenge simple biomedical models, introducing new ways of thinking about how diseases develop. This paper considers the broad implications of lifecourse theory for the maternal and child health (MCH) research agenda. The Lifecourse Health Development model provides an organizing framework for a synthesis of the existing literature on lifecourse health and identification of gaps in knowledge. Priority areas identified for MCH research in order to close these knowledge gaps include: epigenetic mechanisms and their potential mutability; peri-conception as a critical and sensitive period for environmental exposures; maternal health prior to pregnancy; the role of the placenta as an important regulator of the intra-uterine environment; and ways to strengthen early mother-child interactions. Addressing knowledge gaps will require an emphasis on longitudinal rather than cross-sectional studies, long-term (lifetime) rather than short-term perspectives, datasets that include socio-demographic, biologic and genetic data on the same subjects rather than discipline-specific studies, measurement and study of positive health as well as disease states, and study of multi-rather than single generational cohorts. Adoption of a lifecourse-informed MCH research agenda requires a shift in focus from single cause-single disease epidemiologic inquiry to one that addresses multiple causes and outcomes. Investigators need additional training in effective interdisciplinary collaboration, advanced research methodology and higher-level statistical modeling. Advancing a life course health development research agenda in MCH will be foundational to the nation's long-term health.
机译：以生命过程为依据的健康模型从根本上挑战了简单的生物医学模型，引入了思考疾病如何发展的新方法。本文考虑了生命过程理论对母婴健康（MCH）研究议程的广泛影响。生命历程健康发展模型提供了一个组织框架，用于汇总有关生命历程健康和识别知识差距的现有文献。为弥补这些知识鸿沟而确定的妇幼保健研究重点领域包括：表观遗传机制及其潜在变异性;围孕期是环境暴露的关键和敏感时期;怀孕前的孕产妇健康;胎盘作为子宫内环境重要调节剂的作用;以及加强早期母子互动的方法。解决知识鸿沟需要强调纵向研究而不是横断面研究，长期（终身）而不是短期观点，包括同一主题的社会人口统计学，生物学和遗传数据的数据集，而不是特定学科的研究，测量和研究积极健康状况以及疾病状态，并研究多代而非单代人群。采用生命周期信息化的MCH研究议程需要将重点从单一原因-单一疾病流行病学调查转移到解决多种原因和结果的研究。研究人员需要进行有效的跨学科合作，高级研究方法和更高级别的统计模型方面的额外培训。推进妇幼保健的生命历程健康发展研究议程将是国家长期健康的基础。

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