Maternal undernutrition and developmental programming: Implications for offspring reproductive potential

Abstract

A growing body of evidence suggests that the concept of developmental programming can also be applied to reproductive system development and function. Variation in the nutrient supply during fetal life and particularly maternal undernutrition has been proposed as a dominant cause of programming. This chapter reviews the existed data from animal and human studies on the impact of maternal undernutrition on later reproductive health and competence. Specific outcomes depend on the severity, duration, and stage of development when nutritional perturbations are imposed, while sex-specific effects are also manifested. Human cohort studies linking maternal undernutrition, reflected by weight at birth, to a number of reproductive health outcomes and fertility measures are also presented and critically evaluated. Maternal undernutrtion affects offspring gamete quality and reproductive parameters, while effects on fertility are still questionable. Evidence exists for an effect of maternal undernutrition on ovarian reserve, indicating an impact on the time of menopause and reproductive ageing. Mechanisms underlying reproductive programming are still poorly understood. They might include altered cell proliferation/apoptosis, changes in hormone levels or receptor abundance. The periconceptional period, during which major epigenetic changes take place, is of critical importance. Maternal malnutrition can disturb the apposition of epigenetic marks throughout this period, leading to detrimental reproductive outcomes in later life. Evidence also exists that adverse outcomes extend beyond first generation to induce transgenerational effects, through epigenetic mechanisms. Delineating the mechanisms responsible for long-lasting effects of early nutritional programming will help in developing useful interventions during periconceptional and fetal life to ensure reproductive health in later life. Adopting policy strategies to prevent and improve maternal nutritional status is a long-term investment that will benefit the present as well as the future generation.