Metabolic consequences of prematurity.

Area of Science:

• Developmental biology
• Metabolic disease
• Perinatal medicine

Background:

• Major adult diseases are linked to in utero and perinatal events.
• Developmental plasticity influences later-life adaptation via epigenetic and hormonal programming.
• The third trimester is a critical developmental period.

Purpose of the Study:

• To review evidence on the third trimester as a critical period for development, both in utero and ex utero (prematurity).
• To discuss metabolic consequences of prematurity.
• To explore potential treatment implications.

Main Methods:

• Review of epidemiological observations in humans.
• Analysis of experimental evidence in animal models.
• Presentation of data on insulin resistance and hyperinsulinemia in premature infants.

Main Results:

• Prematurity, including the third trimester ex utero, represents a critical developmental period.
• Premature infants exhibit insulin resistance compensated by hyperinsulinemia.
• These metabolic changes are comparable to those in term infants with intrauterine growth retardation.

Conclusions:

• The third trimester is crucial for metabolic programming, extending to premature infants.
• Metabolic consequences of prematurity require consideration for long-term health.
• The fetal salvage hypothesis provides a framework for understanding and treating these conditions.