The Impact of Early-Life Exposures on Women's Reproductive Health in Adulthood.

Purpose of review: To review the effects of early-life, preconception, and prior-generation exposures on reproductive health in women.

Recent findings: Women's early-life factors can affect reproductive health by contributing to health status or exposure level on entering pregnancy. Alternately, they can have permanent effects, regardless of later-life experience. Nutrition, social class, parental smoking, other adverse childhood experiences, environmental pollutants, infectious agents, and racism and discrimination all affect reproductive health, even if experienced in childhood or in utero. Possible transgenerational effects are now being investigated through three- or more-generation studies. These effects occur with mechanisms that may include direct exposure, behavioral, endocrine, inflammatory, and epigenetic pathways.

Summary: Pregnancy is increasingly understood in a life course perspective, but rigorously testing hypotheses on early-life effects is still difficult. In order to improve the health outcomes of all women, we need to expand our toolkit of methods and theory.

Supplementary information: The online version contains supplementary material available at 10.1007/s40471-021-00279-0.