Gender inequalities in early life health outcomes: are they important, and can they be modified?. (360G-Wellcome-094535_Z_10_Z)

As adults, males have higher morbidity and premature mortality than females. They also appear at greater at risk during intrauterine and neonatal life. Our first objective is to quantify the degree of excess risk to males across several linked outcomes in early life. By undertaking a cohesive overview of existing databases, the work will identify whether gender imbalances are increasing or static, and whether patterns are consistent across countries. Understanding the relationships betwe en genetic, environmental and social risk factors is of prime importance in achieving improvements in human health. Whether the gender imbalances in early life outcomes are essentially genetically driven, or are moderated by the maternal environment, has not previously been investigated in humans. Gender-specific differences in placental gene expression in response to maternal environmental cues have been reported in animal models. Our work will investigate whether known risk factors in pregn ancy, including smoking and social class, influence the degree of male disadvantage in early life. Substantial effects would suggest that early interventions should be explored in clinical studies. Since key chronic diseases in adults are in part programmed during early life, such interventions could help close the gender gap in both short- and long-term health.