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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.
Insights
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.
Abstract:
Fetal and neonatal programming is the phenomenon describing deviations from normal developmental patterns. These deviations can increase risks for diseases later in life and are an example of phenotypic plasticity seen throughout nature. For instance, infants born with low birth weight, as a marker of an unfavorable intrauterine environment, are programmed differently and may have an increased risk for multiple diseases in adulthood. These risks include coronary heart disease, increased insulin resistance, hypertension, and imbalances in the immune system. This article discusses mechanisms responsible for fetal and neonatal programming. We also introduce possible changes to current clinical management and practices that reflect the current findings of fetal and neonatal programming.
