Perinatal epidemiology of metabolic syndrome risk factors

Abstract

The concept that events in the perinatal period have far-reaching effects throughout the life course has become increasingly accepted. An enlarging body of literature strongly suggests that exposure to altered maternal nutrition and maternal health status might not cause major malformations, yet can have far-reaching latency effects, such as restricted growth, hypertension, cardiovascular events, and altered renal function in adult life for the exposed offspring. The fetal origins literature also directs attention to intergenerational transmission via the translation of maternal experience from her own gestation and life course onwards into the in utero and child-rearing environments of her offspring. Constitutive of these environments are physiological (e.g., maternal metabolic regulation), psychobehavioral (e.g., stress or smoking), and ecological conditions (e.g., poverty or unstable food supply). In this literature, “programming” is understood as a “setting” of physiological function by conditions operating during a sensitive developmental period to produce long-term effects on function and thereby on health outcomes. This paradigm has particular implications for cardiometabolic disease and namely the metabolic syndrome.