Perinatal Health Programming
Eglė Marija Jakimavičienė, Karolina Bartkutė, Rūta Morkūnienė, Gražina Drąsutienė, Janina Tutkuvienė
Summary
Neonatal body size and subsequent growth is a reflection of parental health and socioeconomic welfare. Fetal growth potential is hereditary; however the real intrauterine development is determined by epigenetic factors - metabolic and hormonal environment that conditions gene expression. An amount of epidemiological and experimental evidence as well as prospective studies on growth programming is rapidly growing. The growth programming is usually definable as a process of growth alteration whereby a stimulus, which affects a fetus at a critical period of development, can have long-term consequences on the health status of the individual. It is hypothesized, that fetal programming may influence development of chronic diseases such as I type diabetes, obesity, osteoporosis, hypertension, cardiovascular disorders and even some kinds of cancer.
Fetal growth depends on maternal age and anthropometric parameters - maternal birth weight, body size before pregnancy and weight gain during pregnancy. Environmental factors (maternal nutrition and addictions) can also have a great influence on newborns growth. Hormones regulating the growth and development of specific fetal tissues likewise play an important role in intrauterine programming. Leptin concentration and its relation to other lipids are currently considered one of the most significant biochemical indicators of fetal growth alteration.
All of the following factors may affect the developing fetus and newborn’s physical status, but nature has devel - oped a protective mechanism, which leads to relatively narrow range of the median size of the newborn over time. Low-birth-weight individual adapts to the al tered met a bolic en vi ronment, and sometimes manifests the catch up phenomenon. This process is especially intense in the light of “thrifty pheno - type”, developed during the perinatal period.
The article reviews the mechanism and the patterns of the fetal health programming and the key factors in this pro cess - ma ternal anthropometric, metabolic and lifestyle contributors to the future growth and disease.
Keywords: newborns, birth weight, growth programming, health programming, mother, anthropometry, metabolism, perinatal growth factors.
