Barker's Hypothesis Among the Global Poor: Positive Long-Term Cardiovascular Effects of in Utero Famine Exposure

An influential literature on the Developmental Origins of Health and Disease (DOHaD) has documented that poor con ditions in utero lead to higher risk of cardio-vas cular dis ease at older ages. Evidence from low-income countries (LICs) has hitherto been miss ing, despite the fact that adverse in utero con di tions are far more common in LICs. We find that Malawians exposed in utero to the 1949 Nyasaland famine have bet-ter cardiovas cular health 70 years later. These find ings highlight the potential context spec ific ity of the DOHaD hypoth e sis, with in utero adver sity hav ing different health impli cations among aging LIC individu als who were exposed to per sistent pov erty.