Abstract
Low birth weight is increasing worldwide. In poor societies, this is linked to maternal undernutrition and in high-income countries it is mainly due to gestational complications associated with the delay in first pregnancy. In both situations, the consequence is fetal undernutrition and deficient growth. In addition to the high risk of perinatal mortality and morbidity, low birth weight has long-term health consequences, increasing the risk of cardiometabolic disease development. The process that associates a deficient fetal growth with a higher risk of adult disease is known as fetal programming. In addition to undernutrition, other stress factors during intrauterine life – such as exposure to toxic substances – also contribute to programming. All of them are known to disrupt the physiological systems responsible for cardiovascular and metabolic control, being oxidative stress a common denominator. Fetal responses to stress factors seem to be modulated by sex. Under adverse intrauterine conditions, females exhibit a better placental adaptation and fetal growth. Later on, during fertile life, estrogens also represent a biological advantage for females, due to their cardiovascular protective actions. However, gender-related factors, such as social or cultural inequities, are likely to counteract the better biological adaptation of females. Sex and gender are often difficult to separate and their relative influence in fetal programming is still far from being understood. Additional research is needed to design-specific interventions and policies in order to reduce the impact of fetal programing on cardiometabolic health in future generations.
David Ramiro-Cortijo and Pilar Rodríguez-Rodríguez contributed equally to this work.
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Abbreviations
- BMI:
-
Body Mass Index
- CMD:
-
Cardiometabolic disease
- CVD:
-
Cardiovascular disease
- GPX:
-
Glutathione peroxidase
- GR:
-
Glutathione reductase
- GSH:
-
Reduced Glutathione
- HPA:
-
Hypothalamic-Pituitary-Adrenal axis
- IUGR:
-
Intrauterine growth restriction
- LBW:
-
Low birth weight
- MDA:
-
Malondialdehyde
- NO:
-
Nitric oxide
- RAAS:
-
Renin-Angiotensin-Aldosterone system
- RNS:
-
Reactive nitrogen species
- ROS:
-
Reactive oxygen species
- SNS:
-
Sympathetic nervous system
- SOD:
-
Superoxide dismutase
- T2DM:
-
Type 2 Diabetes Mellitus
References
Al-Gubory KH (2016) Multiple exposures to environmental pollutants and oxidative stress: is there a sex specific risk of developmental complications for fetuses? Birth Defects Res C Embryo Today 108(4):351–364
Alexander BT, Dasinger JH, Intapad S (2015) Fetal programming and cardiovascular pathology. Compr Physiol. https://doi.org/10.1002/cphy.c140036
Barker DJ, Osmond C (1986) Infant mortality, childhood nutrition, and ischaemic heart disease in England and Wales. Lancet 327(8489):1077–1081
Black RE, Victora CG, Walker SP, Bhutta ZA, Christian P, De Onis M, Ezzati M, Grantham-McGregor S, Katz J, Martorell R (2013) Maternal and child undernutrition and overweight in low-income and middle-income countries. Lancet 382(9890):427–451
Boney CM, Verma A, Tucker R, Vohr BR (2005) Metabolic syndrome in childhood: association with birth weight, maternal obesity, and gestational diabetes mellitus. Pediatrics 115(3):e290–e296
Bréart G, Barros H, Wagener Y, Prati S (2003) Characteristics of the childbearing population in Europe. Eur J Obstet Gynecol and Reprod Biol 111:S45–S52
Cassidy-Vu L, Beck K, Moore JB (2017) Burnout in female faculty members. J Prim Care Community Health 8(2):97–99
Chinnathambi V, Balakrishnan M, Ramadoss J, Yallampalli C, Sathishkumar K (2013) Testosterone alters maternal vascular adaptations: role of the endothelial NO system. Hypertension 61(3):647–654
Dasinger JH, Alexander BT (2016) Gender differences in developmental programming of cardiovascular diseases. Clin Sci 130(5):337–348
Davis JM, Auten RL (2010) Maturation of the antioxidant system and the effects on preterm birth. Semin Fetal Neonatal Med 15(4):191–195. https://doi.org/10.1016/j.siny.2010.04.001
Ekstrom EC, Lindstrom E, Raqib R, El Arifeen S, Basu S, Brismar K, Selling K, Persson LA (2016) Effects of prenatal micronutrient and early food supplementation on metabolic status of the offspring at 4.5 years of age. The MINIMat randomized trial in rural Bangladesh. Int J Epidemiol 45(5):1656–1667
Eriksson JG, Kajantie E, Osmond C, Thornburg K, Barker DJ (2010) Boys live dangerously in the womb. Am J Hum Biol 22(3):330–335
Eriksson JG, Sandboge S, Salonen MK, Kajantie E, Osmond C (2014) Long-term consequences of maternal overweight in pregnancy on offspring later health: findings from the Helsinki birth cohort study. Ann Med 46(6):434–438
Forsdahl A (1977) Are poor living conditions in childhood and adolescence an important risk factor for arteriosclerotic heart disease? Br J Prev Soc Med 31(2):91–95
Gopalakrishnan K, Mishra JS, Chinnathambi V, Vincent KL, Patrikeev I, Motamedi M, Saade GR, Hankins GD, Sathishkumar K (2016) Elevated testosterone reduces uterine blood flow, spiral artery elongation, and placental oxygenation in pregnant rats. Hypertension 67(3):630–639
Guardino CM, Schetter CD, Saxbe DE, Adam EK, Ramey SL, Shalowitz MU (2016) Diurnal salivary cortisol patterns prior to pregnancy predict infant birth weight. Health Psychol 35(6):625
Gupta P, Narang M, Banerjee B, Basu S (2004) Oxidative stress in term small for gestational age neonates born to undernourished mothers: a case control study. BMC Pediatr 4(1):14
Haider BA, Bhutta ZA (2015) Multiple-micronutrient supplementation for women during pregnancy. Cochrane Database of Systematic Reviews, Issue 11, Art. No.: CD004905
Halliwell B, Gutteridge JM (2015) Free radicals in biology and medicine. Oxford University Press, New York
Ingelfinger JR, Nuyt A (2012) Impact of fetal programming, birth weight, and infant feeding on later hypertension. J Clin Hypertens 14(6):365–371
Ko T, Tsai L, Chu L, Yeh S, Leung C, Chen C, Chou H, Tsao P, Chen P, Hsieh W (2014) Parental smoking during pregnancy and its association with low birth weight, small for gestational age, and preterm birth offspring: a birth cohort study. Pediatr Neonatol 55(1):20–27
Lerner DJ, Kannel WB (1986) Patterns of coronary heart disease morbidity and mortality in the sexes: a 26-year follow-up of the Framingham population. Am Heart J 111(2):383–390
Liu L, Pang Z, Sun J, Xue B, Wang S, Ning F, Qiao Q (2017) Exposure to famine in early life and the risk of obesity in adulthood in Qingdao: evidence from the 1959-1961 Chinese famine. Nutr Metab Cardiovasc Dis 2:154–160
Maliqueo M, Echiburú B, Crisosto N (2016) Sex steroids modulate uterine-placental vasculature: implications for obstetrics and neonatal outcomes. Front Physiol 7:152
Maric-Bilkan C, Gilbert EL, Ryan MJ (2014) Impact of ovarian function on cardiovascular health in women: focus on hypertension. Int J Womens Health 6:131–139
Marseglia L, D’Angelo G, Manti S, Reiter RJ, Gitto E (2016) Potential utility of melatonin in preeclampsia, intrauterine fetal growth retardation, and perinatal asphyxia. Reprod Sci 23(8):970–977
Mosca L, Barrett-Connor E, Wenger NK (2011) Sex/gender differences in cardiovascular disease prevention: what a difference a decade makes. Circulation 124(19):2145–2154
Nikolaidis MG, Margaritelis NV, Paschalis V, Theodorou AA, Kyparos A, Vrabas IS (2015) Common questions and tentative answers on how to assess oxidative stress after antioxidant supplementation and exercise. In: Lamprecht M (ed) Antioxidants in sport nutrition. Taylor & Francis Group, LLC, Boca Raton
Nuyt AM (2008) Mechanisms underlying developmental programming of elevated blood pressure and vascular dysfunction: evidence from human studies and experimental animal models. Clin Sci 114(1):1–17
Nykjaer C, Alwan NA, Greenwood DC, Simpson NA, Hay AW, White KL, Cade JE (2014) Maternal alcohol intake prior to and during pregnancy and risk of adverse birth outcomes: evidence from a British cohort. J Epidemiol Community Health 68(6):542–549
Ota E, Hori H, Mori R, Tobe-Gai R, Farrar D (2015) Antenatal dietary education and supplementation to increase energy and protein intake. Cochrane Database of Systematic Reviews, Issue 6, Art.No.: CD000032
Palomba S, Russo T, Falbo A, Di Cello A, Tolino A, Tucci L, La Sala GB, Zullo F (2013) Macroscopic and microscopic findings of the placenta in women with polycystic ovary syndrome. Hum Reprod 28(10):2838–2847
Potdar N, Singh R, Mistry V, Evans M, Farmer P, Konje J, Cooke M (2009) First-trimester increase in oxidative stress and risk of small-for-gestational-age fetus. BJOG Int J Obstet Gynaecol 116(5):637–642
Ramiro-Cortijo D, Herrera T, Rodríguez-Rodríguez P, López De Pablo ÁL, De La Calle M, López-Giménez MR, Mora-Urda AI, Gutiérrez-Arzapalo PY, Gómez-Rioja R, Aguilera Y (2016) Maternal plasma antioxidant status in the first trimester of pregnancy and development of obstetric complications. Placenta 47:37–45
Reiter RJ, Mayo JC, Tan D, Sainz RM, Alatorre-Jimenez M, Qin L (2016) Melatonin as an antioxidant: under promises but over delivers. J Pineal Res 61(3):253–278. https://doi.org/10.1111/jpi.12360
Ridker PM, Rifai N, Rose L, Buring JE, Cook NR (2002) Comparison of C-reactive protein and low-density lipoprotein cholesterol levels in the prediction of first cardiovascular events. N Engl J Med 347(20):1557–1565
Rodríguez-Rodríguez P, López de Pablo AL, García-Prieto CF, Somoza B, Quintana-Villamandos B, Gómez de Diego JJ, Gutierrez-Arzapalo PY, Ramiro-Cortijo D, González MC, Arribas SM (2017) Long term effects of fetal undernutrition on rat heart. Role of hypertension and oxidative stress. PLoS One 12(2):e0171544
Rosenfeld CS (2015) Sex-specific placental responses in fetal development. Endocrinology 156(10):3422–3434
Saker M, Mokhtari NS, Merzouk SA, Merzouk H, Belarbi B, Narce M (2008) Oxidant and antioxidant status in mothers and their newborns according to birthweight. Eur J Obstet Gynecol Reprod Biol 141(2):95–99
Shannon K, Mahmud Z, Asfia A, Ali M (2008) The social and environmental factors underlying maternal malnutrition in rural Bangladesh: implications for reproductive health and nutrition programs. Health Care Women Int 29(8–9):826–840
Simonetti GD, Schwertz R, Klett M, Hoffmann GF, Schaefer F, Wuhl E (2011) Determinants of blood pressure in preschool children: the role of parental smoking. Circulation 123(3):292–298
Singhal A, Lucas A (2004) Early origins of cardiovascular disease: is there a unifying hypothesis? Lancet 363(9421):1642
Smith C, Ryckman K, Barnabei V, Howard B, Isasi C, Sarto G, Tom S, Van Horn L, Wallace R, Robinson J (2016) The impact of birth weight on cardiovascular disease risk in the Women’s Health Initiative. Nutr Metab Cardiovasc Dis 26(3):239–245
Stark MJ, Hodyl NA, Wright IM, Clifton VL (2011) Influence of sex and glucocorticoid exposure on preterm placental pro-oxidant-antioxidant balance. Placenta 32(11):865–870
Stone WL, Bailey B, Khraisha N (2014) The pathophysiology of smoking during pregnancy: a systems biology approach. Front Biosci (Elite Ed) 6:318–328
Tarrade A, Panchenko P, Junien C, Gabory A (2015) Placental contribution to nutritional programming of health and diseases: epigenetics and sexual dimorphism. J Exp Biol 218(Pt 1):50–58
Thompson LP, Al-Hasan Y (2012) Impact of oxidative stress in fetal programming. J Pregnancy. https://doi.org/10.1155/2012/582748
Van Montfoort N, Finken MJ, le Cessie S, Dekker FW, Wit JM (2005) Could cortisol explain the association between birth weight and cardiovascular disease in later life? A meta-analysis. Eur J Endocrinol 153(6):811–817
Ventura SJ, Abma JC, Mosher WD, Henshaw SK (2009) Estimated pregnancy rates for the United States, 1990–2005: an update. Natl Vital Stat Rep 58(4):1–14
Vogt LE, Rukooko B, Iversen PO, Eide WB (2016) Human rights dimensions of food, health and care in children’s homes in Kampala, Uganda – a qualitative study. BMC Int Health Hum Rights 16(1):10
Wemaux-Denis C, Garabedian C, Huc A, Cailleret O, Depoortere MH, Hammou Y, Subtil D (2017) Pregnancy and delivery of teenagers: is the obstetrical prognosis worst between 13–15 years old? Gynecol Obstet Fertil Senol 45(1):5–8
World Health Organization (2014) World Health Organization. Global targets 2025. To improve maternal, infant and young child nutrition. Available www.who.int/nutrition/topics/nutrition. Accessed 17 Oct 2014
Wu F, Tian F, Lin Y, Xu W (2015) Oxidative stress: placenta function and dysfunction. Am J Reprod Immunol 76(4):258–271. https://doi.org/10.1111/aji.12454
Yasmin HN (2016) Epidemiology of malnutrition: maternal and child malnutrition. J Gynecol Neonatal Biol 2:1–5
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Ramiro-Cortijo, D., Rodríguez-Rodríguez, P., López de Pablo, Á.L., López-Giménez, M.R., González, M.C., Arribas, S.M. (2019). Fetal Undernutrition and Oxidative Stress: Influence of Sex and Gender. In: Preedy, V., Patel, V. (eds) Handbook of Famine, Starvation, and Nutrient Deprivation. Springer, Cham. https://doi.org/10.1007/978-3-319-55387-0_32
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