Abstract
“Foetal programming” refers to nutritional and hormonal variations during pregnancy. A maternal proper diet has a fundamental role in decreasing pregnancy complications and to prevent possible diseases in postnatal life. In our narrative review, we analyze and discuss the role of malnutrition during pregnancy and its effects on pre- and postnatal development of embryos. Our review proposes a comprehensive and careful analysis of the studies in this field regarding malnutrition and foetal programming. Evidence shows that nutrient imbalance before implantation may result in somatic hypoevolutism at birth, and endocrine and metabolic dysfunctions in postnatal life. In addition, the maternal malnutrition could exert a suppressive effect on the maternal and foetal immune response. It could also affect both the proliferation of myogenic precursors reducing the number of muscle fibres and the future reproductive maturation with possible consequent impaired fertility and quality of gametes. In conclusion, it is necessary to develop dietary strategies to optimize nutrition, not only during pregnancy but already when it is programmed, in order to improve the outcomes of pregnancy, promote growth, healthy child development, reduce the risk of chronic diseases, and slow down the metabolic decline associated with aging.
Highlights
The nutritional status of the mother at conception is a key factor for development and foetal growth, so a healthy, balanced diet is essential both before and during pregnancy
The so-called “Barker Hypothesis” suggests that chronic diseases in adulthood are in relation with the “foetal programming”, through which any stimulus or insult during embryonic development would have a permanent effect on the structure and physiology of the human body
As we analysed in this narrative review, the Developmental Origins of Health and Disease (DOHaD) hypothesis is supported by both epidemiological evidence and animal experiments showing that, during pregnancy, maternal underand over-nutrition can lead to anomalies in metabolism and body composition in adulthood
Summary
The nutritional status of the mother at conception is a key factor for development and foetal growth, so a healthy, balanced diet is essential both before and during pregnancy. To evaluate the specific influence of different nutrients on prenatal development is difficult, since a severe maternal undernutrition, with a reduction in caloric intake, will trigger a proportional increase in catabolic activity of the maternal tissues that cause the release in blood, and in maternal-foetal circulation, of many amino acids, vitamins and minerals that will balance the deficit “diet” of the foetus Some malformation syndromes, such as congenital defects of the neural tube, are the result of selective deficiency of essential micronutrients during the embryo-foetal development (Table 1) [7]. The hypothesis “Developmental Origins of Health and Disease” (DOHaD) suggests that environmental conditions during foetal and early postnatal development influence health and ability of an individual for the lifetime, with permanent effects on growth, structure and metabolism. In the following paragraphs only some aspects of “foetal programming” will be analysed, including the importance of mother’s diet during pregnancy and its effects on the development of certain tissues and organs of particular importance and the possible consequences on postnatal life
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