Unpacking developmental programming: a conceptual and historical analysis in the context of DOHaD

The Developmental Origins of Health and Disease (DOHaD) paradigm posits that early environmental factors may influence a child’s development and long-term health outcomes. Developmental programming (DP) is central to this paradigm, whereby specific early life exposures during critical periods of development are associated with changes to physiological and metabolic pathways, potentially predisposing individuals to disease. However, no standard definition of DP exists, and various terms have been used to describe similar processes. This analysis aimed to develop a conceptual definition for DP to inform interdisciplinary research, education, and practice. Walker and Avant’s eight-step method was employed to analyze the literature, incorporating elements of Rogers’ evolutionary approach to present the temporal and contextual evolution of the concept. A systematic search of MEDLINE with the EBSCOhost database was performed using the search term “developmental programming,” resulting in 95 titles included in this review. Defining attributes associated with DP include epigenetics, ontogeny, critical periods, and plasticity. Antecedents for DP may include maternal and infant nutrition, maternal disease and medication, lifestyle choices, environmental exposures, and stress. The potential consequences include cardiovascular disease, metabolic disorders, diabetes, neurodevelopmental disorders, endocrine disruption, reproductive issues, and mental health conditions. Effective healthcare provider education, knowledge dissemination, and addressing the social determinants of health through a population health approach are essential to translate DP theory and empirical evidence into practice. A common language and understanding of DP can improve the interdisciplinary advancement of DOHaD research to inform practice and education.