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Metabolic consequences of prematurity.

Wayne S Cutfield1, Paul L Hofman2, Mark A Sperling3

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Early life development impacts adult metabolic health. Prematurity, particularly during the third trimester, can lead to insulin resistance and hyperinsulinemia, influencing long-term well-being.

Keywords:
Type 2 diabetes mellitusfetal programminghyperinsulinemiainsulin resistancemetabolic syndromeprematurity

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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.