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Fetal and neonatal programming: evidence and clinical implications.
Tetyana H Nesterenko1, Hany Aly
1Department of Neonatology, Children's National Medical Center, George Washington University Hospital, Washington, DC, USA.
American Journal of Perinatology
|November 26, 2008
Summary
Fetal and neonatal programming, deviations in development, can lead to adult diseases. Understanding these programming mechanisms can inform clinical practices to mitigate long-term health risks.
Area of Science:
- Developmental biology
- Perinatal medicine
- Endocrinology
Background:
- Fetal and neonatal programming describes altered developmental trajectories.
- These alterations, often linked to intrauterine conditions like low birth weight, increase adult disease susceptibility.
- Phenotypic plasticity underlies these programming effects, impacting long-term health outcomes.
Purpose of the Study:
- To elucidate the mechanisms driving fetal and neonatal programming.
- To explore how these mechanisms influence disease risk later in life.
- To propose clinical practice modifications based on current programming research.
Main Methods:
- Review of existing literature on developmental programming.
- Analysis of studies linking intrauterine environment to adult health.
- Synthesis of evidence on phenotypic plasticity in development.
Main Results:
- Deviations in fetal/neonatal development increase risks for coronary heart disease, insulin resistance, hypertension, and immune system imbalances.
- Low birth weight serves as a key indicator of an unfavorable intrauterine environment and subsequent programming.
- Programming represents a significant example of phenotypic plasticity with lasting health implications.
Conclusions:
- Fetal and neonatal programming mechanisms are critical determinants of adult health.
- Clinical management should adapt to incorporate findings on developmental programming.
- Early life interventions based on programming insights may prevent future chronic diseases.
