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12 - Prenatal hypoxia: relevance to developmental origins of health and disease

Published online by Cambridge University Press:  08 August 2009

By
Dino A. Giussani
Edited by
Peter Gluckman  and
Mark Hanson
Dino A. Giussani
Affiliation:
University of Cambridge
Peter Gluckman
Affiliation:
University of Auckland
Mark Hanson
Affiliation:
University of Southampton
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Summary

Introduction

The compelling evidence linking small size at birth with later cardiovascular disease, obtained from epidemiological studies of human populations from more than a dozen countries (Barker 1998), has clearly renewed and amplified a clinical and scientific interest in the determinants of fetal growth, birthweight and the development of cardiovascular function before and after birth. As early as the 1950s Penrose highlighted that an important determinant of birthweight was the quality of the intrauterine environment, being twice as great a determinant of the rate of fetal growth as the maternal or fetal genotype. Studies of birthweights of relatives (Penrose 1954), together with strong evidence from animal crossbreeding experiments (Walton and Hammond 1938, Giussani et al. 2003), have clearly supported this contention. One of the important modifiers of the fetal environment is maternal nutritional status during pregnancy. The reciprocal association between low birthweight and increased risk of high blood pressure in adulthood, as described by Barker (1998), has exploded into a new field of research investigating the effects of maternofetal nutrition on fetal growth, birthweight and subsequent cardiovascular disease. However, the fetus nourishes itself also with oxygen, and in contrast to the international effort which is assessing the effects of maternofetal undernutrition on early development, the effects of maternofetal under-oxygenation on fetal growth, birthweight and subsequent increased risk of disease have been little addressed.

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Developmental Origins of Health and Disease , pp. 178 - 190
Publisher: Cambridge University Press
Print publication year: 2006

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