Korean J Obstet Gynecol.  2010 Jun;53(6):475-488. 10.5468/kjog.2010.53.6.475.

Fetal origins of adult disease

• Choi GY

• KMID: 2273887
• DOI: http://doi.org/10.5468/kjog.2010.53.6.475

Abstract

Human epidemiological and animal studies show that many chronic adult disease have their antecedents in compromised fetal and early postnatal development. Developmental programming is defined as the response by the developing mammalian organism to a specific challenge during a critical time window that alters the trajectory of development with resulting persistent effects on phenotype. Each individual's phenotype is influenced by the developmental environment as much as their genes. Also, the term 'fetal origins of adult disease' was coined on the basis of the inverse association between low birth weight and blood pressure, adult-onset diabetes, coronary heart disease, and stroke seen in numerous epidemiological studies. However, it seems unlikely that birth weight is involved in causal pathways underlying theses observations, and if it were then the significance to public health of these findings is very limited because of our inability to modify birth weight to a relevant extent in humans. There has been a major focus on maternal nutrition. Important targets for future research include distinction between the effects of different pregnancy conditions, such as maternal malnutrition, preeclampsia, and maternal infection, which may have dissimilar late-life consequences. This will be a crucial step when the associations that are currently emerging will be translated into disease prevention.

Keyword

Fetal development; Adult disease; Intrauterine environment; Birth weight; Maternal nutrition

MeSH Terms

Adult
Animals
Birth Weight
Blood Pressure
Coronary Disease
Fetal Development
Humans
Infant, Low Birth Weight
Infant, Newborn
Malnutrition
Numismatics
Phenotype
Pre-Eclampsia
Pregnancy
Public Health
Stroke

Figure

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  Figure 1 Left panel: the traditional etiologic view of diseases. Right panel: events in utero and during the preimplantation period can shape future health (From Rinaudo PF, et al. Semin Reprod Med 2008; 26: 436-45, with permission from Thieme Medical Publishers).9

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  Figure 2 Incidence of death from cardiovascular disease and incidence of diabetes increase in individuals with smaller birth weight but are lower in individuals with higher birth weight. Each column represent weight in pounds (From Rinaudo PF, et al. Semin Reprod Med 2008; 26: 436-45, with permission from Thieme Medical Publishers).9

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