This is an overview and brief assessment of Hertfordshire Records and DOHAD. It argues that if only two parameters can lead to the revolutionary discovery of link between birth weight and development of diseases later in life, one can only wonder what all might not be revealed with more parameters. Hence, the importance of well-kept and well-maintained medical records for long periods in time.

1. HERTFORDSHIRE
RECORDS : DOHAD
Dr. SB Bhattacharyya
MBBS, MBA, FCGP
Member, EMR Standards Committee, MoH&FW, GoI
Member, Health Informatics Sectional Committee, MHD 17, BIS
President (2010 – 2011), IAMI
Hony. State Secretary (2015), IMA Haryana

2. Hertfordshire Records :: DOHAD
■ Meticulous birth records were maintained throughout Hertfordshire
County, UK, from 1911 to 1948 through the efforts of a dedicated
and visionary midwife, Ethel Margaret Burnside
■ A health visitor subsequently went to each baby’s home throughout
its infancy and recorded its illnesses, development and method of
infant feeding; the baby was then weighed again at 1 year of age.
This information was transcribed into ledgers at the Hertfordshire
county office
■ Through linking these birth records with health in later life by a
research team headed by Dr David Barker led to the development
of the fetal origins hypothesis termed DOHAD (developmental
origins of health and diseases)
■ http://www.mrc.soton.ac.uk/herts/downloads/
Dr SB Bhattacharyya© 2

3. Hertfordshire Records :: DOHAD
■ On studying these records, it was observed that a disproportionate
number of the children whose records were kept had died of coronary
heart disease or related disorders and most of these had occurred among
people who had had low birth weight.
■ It seemed remarkable that the weights of babies measured by Miss
Burnside’s simple spring balances, often in badly lit cottages and hovels,
could so strongly predict events more than 50 years later.
■ These early findings raised the question of what processes are initiated in
foetal and infant life and lead ultimately to disease and premature death.
■ The results of the research have more than justified all the activity.
■ The research led to DOHAD and a Nobel Prize.
Dr SB Bhattacharyya© 3

4. Hertfordshire records & DOHAD –
Lessons Learnt
■ From just the sex and weights at birth and 1 year age, a
definitive correlation could be drawn between them and
development of diseases later on in life that led to a Nobel Prize
(in medicine)
■ One can only wonder what all can be unearthed if more
comprehensive records are available
Dr SB Bhattacharyya© 5

5. Dr SB Bhattacharyya© 6
Thanks!