Wow, the implications of this research are powerful – and sobering:

Some people think we're shaped primarily by genes. Others believe that the environment we grow up in is most important. But now evidence is mounting that a third factor is also critical: our uterine environment before we're even born.

Researchers are finding indications that obesity, diabetes and mental illness among adults are all related in part to what happened in the womb decades earlier.

One of the first careful studies in this field found that birth weight (a proxy for nutrition in the womb) helped predict whether an adult would suffer from heart disease half a century later. Scrawny babies were much more likely to suffer heart problems in middle age.

That study, published in 1989, provoked skepticism at first. But now an array of research confirms that the fetal period is a crucial stage of development that affects physiology decades later.

Perhaps the most striking finding is that a stressful uterine environment may be a mechanism that allows poverty to replicate itself generation after generation. Pregnant women in low-income areas tend to be more exposed to anxiety, depression, chemicals and toxins from car exhaust to pesticides, and they're more likely to drink or smoke and less likely to take vitamin supplements, eat healthy food and get meticulous pre-natal care.

The result is children who start life at a disadvantage — for kids facing stresses before birth appear to have lower educational attainment, lower incomes and worse health throughout their lives. If that's true, then even early childhood education may be a bit late as a way to break the cycles of poverty.

"Given the odds stacked against poor women and their fetuses, the most effective antipoverty program might be one that starts before birth," writes Annie Murphy Paul in a terrific and important new book called "Origins: How the Nine Months Before Birth Shape the Rest of Our Lives."

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October 2, 2010

At Risk From the Womb

By NICHOLAS D. KRISTOF

www.nytimes.com/2010/10/03/opinion/03kristof.html