Handbook of Clinical Gender Medicine. Группа авторов
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Название: Handbook of Clinical Gender Medicine

Автор: Группа авторов

Издательство: Ingram

Жанр: Зарубежная психология

Серия:

isbn: 9783805599306

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СКАЧАТЬ showed that low birth weight is associated with impaired endothelial function in childhood, which is an important risk factor for subsequent cardiovascular disease. The discovery that endothelial dysfunction in adults may be due to prenatal life events is of great importance since it indicates that atherosclerosis may also have its roots in prenatal events which are not genetically controlled. The authors calculated the relation between birth weight and endothelium-dependent flow-mediated dilatation (FMD) and concluded that a 1-kg difference in birth weight is equivalent to 4.5 cigarette pack-years as far as risk for subsequent vascular disease is concerned. This means that the adverse impact of reduced birth weight on vascular function across the birth weight range is as great as the effect of smoking. The correlation between reduced caloric intake during pregnancy and adverse fetal outcomes has been studied in populations in times of war and natural catastrophes. From November 1944 to May 1945, the German blockade of Western Netherlands led to what has been termed ‘The Dutch Famine or Hungerwinter’. Rations went as low as 400 calories a day, equivalent to 25% of the minimal daily requirement. At the Academic Medical Center in Amsterdam, the Dutch Famine Cohort Study was initiated; it investigates the outcomes of men and women who were born in the Wilhelmina Gasthuis in Amsterdam between November 1943 and February 1947 (www.hongerwinter.nl). Thanks to well-preserved documentation, the researchers were able to strongly corroborate the ‘Barker theory’. They found that individuals who were exposed in utero to malnutrition weighed 200-300 g less than controls and suffered later in life from a variety of diseases, including diabetes, cardiovascular disease, higher LDL/HDL ratios, obesity, coagulation disorders, hypertension, pulmonary disease, and renal disease. Ijzerman et al. [12] demonstrated in dizygotic, and hence genetically unlike twins that low birth weight was associated with insulin resistance and lower HDL levels, indicating a pathology independent of genetic factors. Intrauterine malnutrition seems to affect male and fetal fetuses differently. Sardina et al. [13] examined the central anorexigenic effects of insulin in rats. Female but not male adult rats who were exposed to intrauterine undernutrition developed in adulthood adiposity, impairment of hypothalamic insulin signaling, and loss of insulin-induced hypophagia.

      It is becoming increasingly apparent that many forms of adult disease may have their roots in fetal programming and in early childhood. Obesity is one example: obesity has become a major public health problem affecting the majority of adults in the USA. Extremes of birth weight, i.e. low birth weight and increased birth weight, may cause future obesity and metabolic syndrome. It has been shown that prenatal androgen exposure of female mice causes impaired insulin secretion both as an organizational effect and as an activational effect which is based on defective islet cell function. Chronic diseases like osteoporosis, mood disorders, and psychiatric syndromes as well as polycystic ovary syndrome have been related to fetal programming. Other adult diseases such as cardiovascular disease, a variety of metabolic and endocrine pathologies, diabetes, and various other diseases may also be due to inadequate determination of set points during fetal programming. There is now preliminary evidence that eating disorders, which are more common in females that in males, are organized by low levels of prenatal testosterone and then activated by increasing estrogen levels during puberty in girls.

      The Impact of Maternal Prenatal Stress on the Developing Embryo and Fetus

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