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Exploring parental prenatal influences on child health: A multicohort study and data visualisation tool
Gemma C Sharp1,2, Deborah A Lawlor2,3, Kayleigh E Easey2,4
1School of Psychology, Faculty of Health and Life Sciences, University of Exeter, Exeter, United Kingdom.
Plos Medicine
|July 23, 2026
Summary
Socioeconomic factors, not just parental behaviors during pregnancy, significantly influence child health outcomes. Addressing social inequalities is key for effective public health interventions.
Area of Science:
- Reproductive Health
- Pediatric Health
- Social Determinants of Health
Background:
- The Developmental Origins of Health and Disease (DOHaD) hypothesis links early exposures to long-term health.
- Previous research focused on maternal factors, neglecting paternal, postnatal, and social influences.
- A broader perspective is needed to identify effective population health strategies.
Purpose of the Study:
- To systematically explore associations between parental prenatal health behaviors and socioeconomic position with child health outcomes.
- To investigate the influence of maternal versus paternal factors and timing of exposure (prenatal vs. postnatal).
- To provide accessible results for future research and interventions.
Main Methods:
- Utilized harmonized data from four UK and Norway longitudinal cohort studies (births 1991-2008).
- Examined 72 child health outcomes up to age 11, analyzing parental smoking, alcohol, and caffeine consumption, and socioeconomic position (SEP).
- Employed meta-analysis, Mendelian randomization-informed approaches, negative controls, and dose-response analyses for causal inference.
Main Results:
- Found limited evidence for widespread, large effects of parental prenatal health behaviors on child health (only 6% of analyses showed significant effects).
- Maternal smoking was linked to small for gestational age, higher BMI, depressive, and behavioral issues; partner smoking associated with BMI and social communication difficulties.
- Low socioeconomic position (SEP) showed stronger associations with child health outcomes (15% of analyses) than parental health behaviors (smoking 6%, alcohol 3%, caffeine 0.4%).
Conclusions:
- Wider familial socioeconomic conditions appear to be more critical determinants of child health than specific prenatal parental behaviors.
- Public health interventions may be more effective targeting social inequalities rather than solely individual behaviors or maternal factors.
- The 'EPoCH Explorer' web app is available for researchers to validate and extend these findings across different datasets and contexts.
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