Molecular mechanisms involved in fetal programming and disease origin in adulthood

J Pediatr Endocrinol Metab. 2023 May 29;36(7):615-627. doi: 10.1515/jpem-2022-0491. Print 2023 Jul 26.

Abstract

Fetal programming occurs during the gestational age when exposure to environmental stimuli can cause long-term changes in the fetus, predisposing it to develop chronic non-communicable diseases (CNCD) in adulthood. Herein, we summarized the role of low-calorie or high-fat diets during pregnancy as fetal programming agents that induce intrauterine growth restriction (IUGR), amplified de novo lipogenesis, and increased amino acid transport to the placenta, which favor the CNCD onset in the offspring. We also outlined how maternal obesity and gestational diabetes act as fetal programming stimuli by reducing iron absorption and oxygen transport to the fetus, stimulating inflammatory pathways that boost neurological disorders and CNCD in the progeny. Moreover, we reviewed the mechanisms through which fetal hypoxia elevates the offspring's risk of developing hypertension and chronic kidney disease in adult life by unbalancing the renin-angiotensin system and promoting kidney cell apoptosis. Finally, we examined how inadequate vitamin B12 and folic acid consumption during pregnancy programs the fetus to greater adiposity, insulin resistance, and glucose intolerance in adulthood. A better understanding of the fetal programming mechanisms may help us reduce the onset of insulin resistance, glucose intolerance, dyslipidemia, obesity, hypertension, diabetes mellitus, and other CNCD in the offspring during adulthood.

Keywords: chronic non-communicable diseases; disease origin; embryonic development; fetal programming; fetus; gestational age; pregnancy.

Publication types

  • Review

MeSH terms

  • Adult
  • Female
  • Fetal Development
  • Fetal Growth Retardation / etiology
  • Glucose Intolerance* / complications
  • Humans
  • Hypertension* / complications
  • Insulin Resistance*
  • Obesity / etiology
  • Pregnancy
  • Prenatal Exposure Delayed Effects*