Abnormal Development - Fetal Origins Hypothesis
Introduction
Maternal derived abnormalities relate to lifestyle, environment and nutrition and while some of these directly effect embryonic development, there is also growing evidence that some effects are more subtle and relate to later life health events. This theory is based on the early statistical analysis carried out by Barker of low birth weight data collected in the early 1900's in the south east of England which he then compared with these same babies later health outcomes. The theory was therefore originally called the "Barker Hypothesis" and has recently been renamed as "fetal origins" or "programming".
There have also been some issues relating to how the data is both collected and analyzed. (see Lucas reference)
Some Recent Findings
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Barker Hypothesis
There were some key papers by David Barker that initially studied UK birth weight data that gave rise to this area of research.[5][6][7]
“The fetal origins hypothesis states that fetal undernutrition in middle to late gestation, which leads to disproportionate fetal growth, programmes later coronary heart disease.”
Neural Effects
The hypothesis proposes influences cause permanent changes in embryo/fetus, low birth weight, predisposition to chronic disease in adult life. Malnutrition in utero affects brain development, "low birth weight" or intrauterine growth restricted babies fare less well on measures of mental development in later life studies compared low birth weight babies (<2500 g) with controls, show impairment in neuro developmental tests up to age 11.
Intelligence is a combination of genetic and environmental influences (relative contributions of which are not yet established) and may vary over lifespan.
(Modified Text from[8] Note the commment made by Emeritus Professor P Pharaoh "One caveat that should be borne in mind, concerns the tests that are used to assess cognitive function. What do these tests actually measure? Ideally they measure innate mental ability, whatever that is, at a point in time.")
NCBI Bookshelf
Resources available from online textbooks freely available at National Library of Medicine (USA), National Center for Biotechnology Information.
Health Services/Technology Assessment Text (HSTAT)
Evidence table 5B. Studies Evaluating Association of LBW of Audiology Outcomes Part II
Fetal Growth Articles
Fetal growth.[9] "Recent epidemiological and experimental studies show that abnormal fetal growth can lead to serious complications, including stillbirth, perinatal morbidity and disorders extending well beyond the neonatal period. It is now clear that the intrauterine milieu is as important as genetic endowment in shaping the future health of the conceptus. Maternal characteristics such as weight, height, parity and ethnic group need to be adjusted for, and pathological factors such as smoking excluded, to establish appropriate standards and improve the distinction between what is normal and abnormal. Currently, the aetiology of growth restriction is not well understood and preventative measures are ineffective. Elective delivery remains the principal management option, which emphasizes the need for better screening techniques for the timely detection of intrauterine growth failure."
Fetal growth and long-term consequences in animal models of growth retardation.[10] "Perturbations of the maternal environment involve an abnormal intrauterine milieu for the developing fetus. The altered fuel supply (depends on substrate availability, placental transport of nutrients and uteroplacental blood flow) from mother to fetus induces alterations in the development of the fetal endocrine pancreas and adaptations of the fetal metabolism to the altered intrauterine environment, resulting in intrauterine growth retardation. The alterations induced by maternal diabetes or maternal malnutrition (protein-calorie or protein deprivation) have consequences for the offspring, persisting into adulthood and into the next generation."
Birth Terms
- Premature infant - An infant born before 37 weeks of estimated gestational age
- Low birth weight - Birth weight < 2,500 g (5 lb, 8 oz)
- Very low birth weight - Birth weight < 1,500 g (3 lb, 5 oz)
- Extremely low birth weight - Birth weight < 1,000 g (2 lb, 3 oz)
References
Search Pubmed
Search Pubmed - fetal origins hypothesis
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Cite this page: Hill, M.A. (2024, April 19) Embryology Abnormal Development - Fetal Origins Hypothesis. Retrieved from https://embryology.med.unsw.edu.au/embryology/index.php/Abnormal_Development_-_Fetal_Origins_Hypothesis
- © Dr Mark Hill 2024, UNSW Embryology ISBN: 978 0 7334 2609 4 - UNSW CRICOS Provider Code No. 00098G