title: DOHaD at the intersection of maternal immune activation and maternal metabolic stress: a scoping review.
abstract: The prenatal environment is now recognized as a key driver of non-communicable disease risk later in life. Within the developmental origins of health and disease (DOHaD) paradigm, studies are increasingly identifying links between maternal morbidity during pregnancy and disease later in life for offspring. Nutrient restriction, metabolic disorders during gestation, such as diabetes or obesity, and maternal immune activation provoked by infection have been linked to adverse health outcomes for offspring later in life. These factors frequently co-occur, but the potential for compounding effects of multiple morbidities on DOHaD-related outcomes has not received adequate attention. This is of particular importance in low- or middle-income countries (LMICs), which have ongoing high rates of infectious diseases and are now experiencing transitions from undernutrition to excess adiposity. The purpose of this scoping review is to summarize studies examining the effect and interaction of co-occurring metabolic or nutritional stressors and infectious diseases during gestation on DOHaD-related health outcomes. We identified nine studies in humans - four performed in the United States and five in LMICs. The most common outcome, also in seven of nine studies, was premature birth or low birth weight. We identified nine animal studies, six in mice, two in rats and one in sheep. The interaction between metabolic/nutritional exposures and infectious exposures had varying effects including synergism, inhibition and independent actions. No human studies were specifically designed to assess the interaction of metabolic/nutritional exposures and infectious diseases. Future studies of neonatal outcomes should measure these exposures and explicitly examine their concerted effect.
authors.affiliation: 1Department of Pathology, Microbiology, and Immunology,Vanderbilt UniversityMedical Center,Nashville, Tennessee,United States of America.
authors.forename: J A
authors.identifier: http://orcid.org/0000-0002-4086-057X
authors.initials: JA
authors.lastname: Goldstein
authors.affiliation: 2Medical Research Council Developmental Pathways for Health Research Unit,University of the Witwatersrand,Johannesburg,South Africa.
authors.forename: S A
authors.initials: SA
authors.lastname: Norris
authors.affiliation: 1Department of Pathology, Microbiology, and Immunology,Vanderbilt UniversityMedical Center,Nashville, Tennessee,United States of America.
authors.forename: D M
authors.initials: DM
authors.lastname: Aronoff
mesh_terms: D000818:Animals; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007230:Infant, Low Birth Weight / Q000276:immunology / Q000378:metabolism; D008659:Metabolic Diseases / Q000453:epidemiology / Q000276:immunology* / Q000378:metabolism*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology / Q000276:immunology* / Q000378:metabolism*; D047928:Premature Birth / Q000276:immunology / Q000378:metabolism; D011446:Prospective Studies; D016032:Randomized Controlled Trials as Topic; D012189:Retrospective Studies; D013312:Stress, Physiological / Q000502:physiology*
keywords: child growth and health; obesity; outcome/system; pregnancy