Stressed at Birth: Investigating Fetal, Perinatal and Infant Growth and Health Disruption.

Abstract

The trajectory and success of fetal, perinatal and infant growth and development is regulated and/or altered by a multitude of intrinsic and extrinsic factors. Both growth and development exhibit a degree of plasticity and thus may fluctuate in response to early life adversity. Non-adult skeletal remains therefore provide a tangible record of growth and health disruption as a consequence of stress in the early life course.

This study represents the first extensive and integrated osteological and palaeopathological assessment of fetal, perinatal and infant growth and health disruption. It seeks to determine skeletal responses to adversity and to provide a comprehensive consideration of the potential pathogeneses, etiologies and contextual factors which can affect intrauterine and postnatal health and growth.

A total of 423 individuals from 15 different archaeological and historical samples, spanning a ~2000-year time period, have been considered for analysis. Assessment reveals a complex and intricate narrative of health and growth disruption, revealing evidence of chronic early life exposure to stress, which resulted in death for these individuals. A total of 192 individuals had both dental and skeletal elements preserved and 20% (N=39) of these were found to show significant evidence of growth disruption. Individuals from all time periods are represented, but those from post-Medieval London were found to exhibit the highest frequency and severest evidence of growth disruption. Palaeopathological analysis revealed high prevalence rates of both cranial (70%) and postcranial (30%) lesions, with cranial changes consistently more common throughout all periods and samples. New bone formation was the most commonly identified type of lesion and is considered to reflect evidence of both nutritional and infectious health stressors. Furthermore, it is suggested that socioeconomic status was a dominant factor in regulating exposure to stress. Additionally, periods of rapid cultural change also correlated with increased evidence of fetal and infant stress.

This thesis makes a number of important contributions regarding fetal, perinatal and infant growth and health during the early life course.