Perinatal Origins of Adult Disease

Abstract

Epidemiological and experimental studies have shown that the peri-conception period, pregnancy, and infancy are windows of particular sensibility to environmental clues which influence lifelong trajectories across health and disease. Nutrition, stress, and toxins induce epigenetic marks that control long-term gene expression patterns and can be transmitted transgenerationally. Chronic diseases of adulthood such as hypertension, diabetes, and obesity thus have early, developmental origins in the perinatal period. The early epigenome, in interaction with other actors such as the microbiome, add powerful layers of diversity to the biological predisposition generated by the genome. Such “programming” is a normal, adaptive component of development, including in normal pregnancies and births. However, perinatal disease, either maternal (such as pre-eclampsia, ges­tational diabetes, or inflammatory disease) or fetal, and neonatal diseases (such as intrauterine growth restriction and preterm birth) are major conditions of altered programming, translated into an increased risk for chronic disease in these patients when they reach adulthood. Early prevention, optimal perinatal nutrition, and specific follow-up measures are key factors in the early preservation of long-term health.

Prematurity With Extrauterine Growth Restriction Increases the Risk of Higher Levels of Glucose, Low-Grade of Inflammation and Hypertension in Prepubertal Children

“…Despite the major improvement in the survival of preterm infants (12), neonatal advances have remained insufficient to improve their rate of growth, and EUGR continues to be a frequent complication in neonatal units (1,13,14). The growth of very preterm infants during the postconceptional period is likely to be in a similar environment as the condition of intrauterine growth restriction (IUGR), which has been associated with different pathologies such as obesity, diabetes, metabolic syndrome and CVD (3,15). Therefore, EUGR in preterm infants could also be unfavourable, and similar cardiometabolic outcomes should be expected in this population.…”

Amyotrophic lateral sclerosis: Origins traced to impaired balance between neural excitation and inhibition in the neonatal period

“…7 The present report will consider whether the complex cascade of events that culminate in the clinical syndrome of ALS may have their origins during neonatal life, when adverse fetal and early childhood exposures may predispose to disease manifesting in adulthood. 8 During the first 2 weeks of life, the excitatory-toinhibitory functional switch of γ-aminobutyric acid (GABA) takes place. 9,10 Improper timing of the GABA switch can alter neural transmission and network activity later in life.…”

“…Normal functioning of the central nervous system (CNS) in the adult requires correctly timed events during development, and, if neuronal networks are improperly developed, there can be life‐long effects . The present report will consider whether the complex cascade of events that culminate in the clinical syndrome of ALS may have their origins during neonatal life, when adverse fetal and early childhood exposures may predispose to disease manifesting in adulthood …”

Sharing Progress in Neonatology (SPIN): Moving towards Individualized Prenatal and Neonatal Care

“…Umberto Simeoni from Lausanne, Switzerland, described the effects of pre-and perinatal programming in his lecture on the "Perinatal origins of adult disease" [8]. Diabetes, hypertension, obesity, and the metabolic syndrome in adult life are just some of the disorders that have their origins in pregnancy and early life.…”

“…Diabetes, hypertension, obesity, and the metabolic syndrome in adult life are just some of the disorders that have their origins in pregnancy and early life. Early prevention, optimal prenatal nutrition, and specific followup measures are key factors in early preservation of longterm health [8]. Professor Simeoni shared recent findings on these topics, but also pointed out how much further research is needed in this important area [9].…”