Intrauterine nutrition: long-term consequences for vascular health

Abstract

There is a growing body of evidence that improper intrauterine nutrition may negatively influence vascular health in later life. Maternal malnutrition may result in intrauterine growth retardation and, in turn, metabolic disorders such as insulin resistance, diabetes, hypertension, and dyslipidemia, and also enhanced risk of atherosclerosis and cardiovascular death in the offspring. Energy and/or protein restriction is the most critical determinant for fetal programming. However, it has also been proposed that intrauterine n-3 fatty acid deficiency may be linked to later higher blood pressure levels and reduced insulin sensitivity. Moreover, it has been shown that inadequate supply of micronutrients such as folate, vitamin B12, vitamin A, iron, magnesium, zinc, and calcium may contribute to impaired vascular health in the progeny. In addition, hypertensive disorders of pregnancy that are linked to impaired placental blood flow and suboptimal fetal nutrition may also contribute to intrauterine growth retardation and aggravated cardiovascular risk in the offspring. On the other hand, maternal overnutrition, which often contributes to obesity and/or diabetes, may result in macrosomia and enhanced cardiometabolic risk in the offspring. Progeny of obese and/or diabetic mothers are relatively more prone to develop obesity, insulin resistance, diabetes, and hypertension. It was demonstrated that they may have permanently enhanced appetites. Their atheromatous lesions are usually more pronounced. It seems that, particularly, a maternal high-fat/junk food diet may be detrimental for vascular health in the offspring. Fetal exposure to excessive levels of saturated fatty and/or n-6 fatty acids, sucrose, fructose and salt, as well as a maternal high glycemic index diet, may also contribute to later enhanced cardiometabolic risk.

Maternal High-Fat Diet Modifies the Immature Hippocampus Vulnerability to Perinatal Asphyxia in Rats

“…Maternal HFD-induced obesity raises the rate of difficult deliveries and neonatal mortality [2]. The long-term consequences of gestational high-fat intake include metabolic, cardiovascular, neurologic, and psychiatric pathologies leading to a decrease in the quality of life [3].…”

A maternal high salt diet disturbs cardiac and vascular function of offspring

“…Thus, altered NOmediated vascular relaxation represents a well-documented example of the effects of dietary salt on cardiovascular function. Vascular health has been found to have many of its origins early in development [42]. Maternal malnutrition has been observed to not only increase the salt sensitivity of blood pressure of offspring [35], but to also impair their vasodilatory response to NO [5,40].…”

Foetal Programming in a Diabetic Pregnancy: Long-Term Implications for the Offspring

“…Hyperinsulinaemia may induce leptin resistance and alter the leptin/ insulin feedback system affecting the appetite regulation by the hypothalamus 52 . Some researchers also suggest the involvement of other mechanistic pathways, including oxidative stress, foetal dyslipedaemia and inflammation in the long-term programming for offspring NCD risks 53 . It has been shown in animal and human studies that maternal hyperglycaemia increases oxidative stress, and induces low-grade inflammation in the foetal cells 53 .…”

“…Some researchers also suggest the involvement of other mechanistic pathways, including oxidative stress, foetal dyslipedaemia and inflammation in the long-term programming for offspring NCD risks 53 . It has been shown in animal and human studies that maternal hyperglycaemia increases oxidative stress, and induces low-grade inflammation in the foetal cells 53 . These conditions result in impaired vascular development, endothelial dysfunction and aberrations in the neuroendocrine development and functioning.…”