Low Birthweight as a Risk Factor for Non-communicable Diseases in Adults

Abstract

According to studies undertaken over the past 40 years, low birthweight (LBW) is not only a significant predictor of perinatal death and morbidity, but also increases the risk of chronic non-communicable diseases (NCDs) in adulthood. The purpose of this paper is to summarize the research on LBW as a risk factor for NCDs in adults. The Barker hypothesis was based on the finding that adults with an LBW or an unhealthy intrauterine environment, as well as a rapid catch-up, die due to NCDs. Over the last few decades, terminology such as thrifty genes, fetal programming, developmental origins of health and disease (DOHaD), and epigenetic factors have been coined. The most common NCDs include cardiovascular disease, diabetes mellitus type 2 (DMT2), hypertension (HT), dyslipidemia, proteinuria, and chronic kidney disease (CKD). Studies in mothers who experienced famine and those that solely reported birth weight as a risk factor for mortality support the concept. Although the etiology of NCD is unknown, Barry Brenner explained the notion of a low glomerular number (nGlom) in LBW children, followed by the progression to hyperfiltration as the physiopathologic etiology of HT and CKD in adults based on Guyton's renal physiology work. Autopsies of several ethnic groups have revealed anatomopathologic evidence in fetuses and adult kidneys. Because of the renal reserve, demonstrating renal function in proportion to renal volume in vivo is more difficult in adults. The greatest impact of these theories can be seen in pediatrics and obstetrics practice.

Fetal spina bifida associates with dysregulation in nutrient-sensitive placental gene networks: findings from a matched case-control study

“…Last, we found dysregulation in gene networks related to inflammation and immune regulation in cases. Collectively, our findings suggest that the placental transcriptome is altered in fetuses with SB, and that placental dysfunction in fetuses with SB may, in part, underlie poor fetal growth, and contribute to subsequent comorbidities 54 and increased risk of mortality 55 .…”

Heterogeneity of the placenta in health and disease explored through integrated histology, gene expression and modelling

“…The gestational age at diagnosis is used to further subdivide FGR into early-onset, detected before 32 weeks of gestation, and late-onset according to international consensus (7). Neonates born following FGR have an increased risk of developing health problems, both in the immediate postnatal period including low blood sugars and poor temperature regulation and feeding, but also in later adult life in the form of cardiovascular and metabolic disease (8, 9). Management of pregnancies affected by FGR can be challenging, as timing of delivery needs to be judged well, to balance the hazards of preterm birth against the risks of irreversible damage secondary to intrauterine hypoxia and nutritional deficiency or even stillbirth (10).…”

Maternal determinants of average weekly fetal weight gain in Yogyakarta, Indonesia

“…Several studies confirmed that LBW is strongly associated with a higher risk of neonatal death, stunting, lower academic performance, mental health, and some non-communicable diseases (NCDs) including type 2 diabetes mellitus, hypertension, and cardiovascular diseases (CVDs) in later life. [1][2][3][4][5] The global prevalence of LBW is estimated at 14.6 to 20% of all live births, of which almost 95.6% are in developing countries. It is also associated with 60 to 80% of neonatal deaths worldwide.…”