Long-Term Metabolic Consequences of Intrauterine Growth Restriction
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NEONATOLOGY (C JULIANO AND K GLUCK, SECTION EDITORS)
Long-Term Metabolic Consequences of Intrauterine Growth Restriction Kyoung Eun Joung 1,2 & Jieun Lee 3 & Jae Hyun Kim 4 Published online: 3 April 2020 # Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose of Review To summarize recent findings on the associations of intrauterine growth restriction (IUGR) and long-term metabolic consequences such as obesity, type 2 diabetes (T2D), and cardiovascular diseases and the underlying mechanisms. Recent Findings Recent evidence suggests that metabolic diseases such as obesity, T2D, hypertension, and coronary artery disease are related to developmental programming in fetal period and early childhood. Rapid postnatal catch-up growth is also an important factor that contributes to the development of these long-term metabolic complications. The underlying mechanisms include oxidative stress, changes in hormonal milieu, vascular endothelial dysfunction, epigenetic regulation, and the potential alteration of microbiome. Summary Fetal and early life environment is an important determinant of long-term cardiometabolic risks. Children with IUGR need close follow-up for early detection of these complications. Keywords Intrauterine growth restriction . Metabolic complication . Obesity . Type 2 diabetes . Hypertension . Coronary artery disease
Abbreviations DOHaD Developmental origins and health and disease IUGR Intrauterine growth restriction T2D Type 2 diabetes BMI Body mass index LBW Low birth weight OR Odds ratio
This article is part of the Topical Collection on Neonatology * Kyoung Eun Joung [email protected] 1
Division of Neonatology and Newborn Medicine, Department of Pediatrics, Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114, USA
2
Harvard Medical School, 25 Shattuck St, Boston, MA 02115, USA
3
Department of Pediatrics, Inje University Ilsan Paik Hospital, 170 Juhwa-ro, Ilsanseo-gu, Goyang 10380, South Korea
4
Department of Pediatrics, Seoul National University Bundang Hospital, 82, Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam 13620, South Korea
CI BP NO
Confidence interval Blood pressure Nitric oxide
Introduction The rising incidence of metabolic diseases is a global health concern. In the USA, the incidence of obesity in adults was reported to be 39.8% in 2015–2016 [1]. In addition, since 1980, obesity prevalence among children and adolescents has almost tripled, and 18.5% of children and adolescents aged 2–19 years are obese [1]. Obesity increases the risks for many diseases including type 2 diabetes (T2D), hypertension, coronary heart disease, and stroke [2]. Effective strategies to identify individuals at high risk of developing these metabolic complications will be crucial in the prevention of these diseases. The concept of developmental origins of health and disease (DOHaD) has been developed since Barker et al. reported high incidence of ischemic heart disease from adults who were born at low birth weight [3]. Multiple subsequent epidemiologic studies have sho
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