The 'Developmental Origins' Hypothesis: relevance to the obstetrician and gynecologist.
The recognition of 'fetal origins of adult disease' has placed new responsibilities on the obstetrician, as antenatal care is no longer simply about ensuring good perinatal outcomes, but also needs to plan for optimal long-term health for mother and baby. Recently, it has become clear that the intrauterine environment has a broad and long-lasting impact, influencing fetal and childhood growth and development as well as future cardiovascular health, non-communicable disease risk and fertility. This article looks specifically at the importance of the developmental origins of ovarian reserve and ageing, the role of the placenta and maternal nutrition before and during pregnancy. It also reviews recent insights in developmental medicine of relevance to the obstetrician, and outlines emerging evidence supporting a proactive clinical approach to optimizing periconceptional as well as antenatal care aimed to protect newborns against long-term disease susceptibility.
1Centre for Human Development, Stem Cells and Regeneration, Faculty of Medicine,University of Southampton,Southampton,UK.
A J
AJ
Kermack
2Human Development and Health Academic Unit, Faculty of Medicine,University of Southampton,Southampton,UK.
B B
BB
Van Rijn
1Centre for Human Development, Stem Cells and Regeneration, Faculty of Medicine,University of Southampton,Southampton,UK.
F D
FD
Houghton
2Human Development and Health Academic Unit, Faculty of Medicine,University of Southampton,Southampton,UK.
P C
PC
Calder
2Human Development and Health Academic Unit, Faculty of Medicine,University of Southampton,Southampton,UK.
I T
IT
Cameron
2Human Development and Health Academic Unit, Faculty of Medicine,University of Southampton,Southampton,UK.
N S
NS
Macklon
D000328:Adult; D002319:Cardiovascular System / Q000503:physiopathology*; D047108:Embryonic Development; D005260:Female; D047109:Fetal Development; D006176:Gynecology; D006801:Humans; D039382:Maternal Nutritional Physiological Phenomena; D009774:Obstetrics; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects
developmental origins; ovary; placenta; pregnancy