Nutritional Programming of Foetal Development: Endocrine Mediators and Long-Term Outcomes for Cardiovascular Health

Epidemiological studies on historical and contemporary populations indicate that the uterine environment is a major factor contributing to later health and disease in the resulting offspring. These findings are supported by experimental studies which indicate that both macro and micronutrient deficiencies have long-term health implications for the offspring. Maternal nutrition directly determines foetal and placental growth and influences the in utero endocrine environment. A reduction in maternal food intake at defined stages of gestation does not necessarily compromise foetal growth but reprogrammes foetal sensitivity to later stress. When nutrient restriction is targeted over the period of maximal placental growth placental size is restricted in conjunction with a reduction in maternal plasma concentrations of counterregulatory hormones including cortisol. These maternal adaptations appear to be accompanied by an increased sensitivity to these hormones in their resulting offspring. In late gestation, foetal growth can be compromised by a reduction in nutrient supply, but long term outcomes from nutrient restriction in early, early to mid or late gestation are very different. The maternal nutrient and endocrine environments therefore have pronounced influences on foetal endocrine sensitivity that depends on stage of gestation and result in long term outcomes predicted to compromise later health and well being.