Abstract
The hypothesis of fetal origins to adult diseases proposes that metabolic chronic disorders, including cardiovascular diseases, diabetes, and hypertension originate in the developmental plasticity due to intrauterine insults. These processes involve an adaptative response by the fetus to changes in the environmental signals, which can promote the reset of hormones and of the metabolism to establish a "thrifty phenotype". Metabolic alterations during intrauterine growth restriction can modify the fetal programming. The present nonsystematic review intended to summarize historical and current references that indicated that developmental origins of health and disease (DOHaD) occur as a consequence of altered maternal and fetal metabolic pathways. The purpose is to highlight the potential implications of growth factors and adipokines in "developmental programming", which could interfere in the development by controlling fetal growth patterns. These changes affect the structure and the functional capacity of various organs, including the brain, the kidneys, and the pancreas. These investigations may improve the approach to optimizing antenatal as well as perinatal care aimed to protect newborns against long-term chronic diseases.
Highlights
Intrauterine growth restriction is associated with increased morbidity and mortality in the perinatal period, with implications for later adult life diseases.[1]
Several studies have demonstrated adaptive mechanisms that occur during growth restriction. These chronic diseases may occur in combination or not, and have imbalance of homeostasis involving the common regulatory hormonal axis, with potential effects on fetal development as well as on long-term adult health.[3,4,5]
The thrifty phenotype favors survival, it may have a developmental impact by affecting the hormonal regulatory axis that regulates fetal growth.[7]. These processes involve hormonal factors, such as insulin-like growth factor (IGF) system and insulin, which participate in the regulation of fetal growth, and which can modify the fetal development during intrauterine growth restriction.[3,4,5]
Summary
Intrauterine growth restriction is associated with increased morbidity and mortality in the perinatal period, with implications for later adult life diseases.[1].
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More From: Revista Brasileira de Ginecologia e Obstetrícia / RBGO Gynecology and Obstetrics
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