title: Early life influences on cardio-metabolic disease risk in aboriginal populations--what is the evidence? A systematic review of longitudinal and case-control studies.
abstract: BACKGROUND
  We systematically reviewed the published evidence for the developmental origins of health and disease hypothesis among aboriginal populations from Australia, Canada, New Zealand and the USA.
  
  
  METHODS
  Medline, EMBASE and the Informit Health databases were systematically searched (March 2012) using medical subject headings and keywords for studies that examined the effect of prenatal factors and birth outcomes on later life (≥3 years) cardio-metabolic diseases. Quality of studies was independently assessed by two reviewers using a risk of bias assessment tool; main findings from studies with a low to moderate risk of bias were summarised qualitatively.
  
  
  RESULTS
  In all, 844 studies were found; 50 were included in the review of which 41 had a low-moderate risk of bias. There was strong evidence for an association between birth weight and type 2 diabetes (6/7 studies), impaired kidney function (6/7 studies) and high blood pressure (5/6 studies), whereas there was limited evidence for an association with metabolic abnormalities (4/7 studies) and adiposity (4/7). Exposure to maternal diabetes was strongly associated with type 2 diabetes (9/10 studies) and metabolic abnormalities (5/7 studies), whereas the association with adiposity was low (3/9 studies); the limited number of studies, to date, also show a relationship with high blood pressure (2/2 studies).
  
  
  CONCLUSIONS
  This review highlights that interventions to reduce the burden of cardio-metabolic disease among aboriginal populations should focus on improving maternal health, particularly by reducing the prevalence of diabetes in pregnancy. Future research should also be directed towards potential protective actions, such as breastfeeding.
authors.affiliation: Preventative Health, Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia.
authors.forename: Bridgette J
authors.initials: BJ
authors.lastname: McNamara
authors.forename: Lina
authors.initials: L
authors.lastname: Gubhaju
authors.forename: Catherine
authors.initials: C
authors.lastname: Chamberlain
authors.forename: Fiona
authors.initials: F
authors.lastname: Stanley
authors.forename: Sandra J
authors.initials: SJ
authors.lastname: Eades
mesh_terms: D050154:Adiposity; D000293:Adolescent; D000328:Adult; D001315:Australia / Q000453:epidemiology; D001724:Birth Weight; D002170:Canada / Q000453:epidemiology; D002318:Cardiovascular Diseases / Q000208:ethnology*; D002648:Child; D002675:Child, Preschool; D003920:Diabetes Mellitus / Q000208:ethnology; D005260:Female; D047109:Fetal Development; D006801:Humans; D007198:Indians, North American / Q000706:statistics & numerical data; D007223:Infant; D007231:Infant, Newborn; D008137:Longitudinal Studies; D008297:Male; D008659:Metabolic Diseases / Q000208:ethnology*; D008875:Middle Aged; D009520:New Zealand / Q000453:epidemiology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000208:ethnology; D011297:Prenatal Exposure Delayed Effects / Q000208:ethnology; D014481:United States / Q000453:epidemiology