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The ‘Developmental Origins’ Hypothesis: relevance to the obstetrician and gynecologist

Part of: Sir David Barker Symposium

Published online by Cambridge University Press:  08 September 2015

A. J. Kermack ,
B. B. Van Rijn ,
F. D. Houghton ,
P. C. Calder ,
I. T. Cameron  and
N. S. Macklon
A. J. Kermack
Affiliation:
Centre for Human Development, Stem Cells and Regeneration, Faculty of Medicine, University of Southampton, Southampton, UK Human Development and Health Academic Unit, Faculty of Medicine, University of Southampton, Southampton, UK NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust and University of Southampton, Southampton, UK Department of Obstetrics and Gynaecology, Complete Fertility Centre, Princess Anne Hospital, Southampton, UK
B. B. Van Rijn
Affiliation:
Human Development and Health Academic Unit, Faculty of Medicine, University of Southampton, Southampton, UK Wilhelmina Children’s Hospital Birth Centre, UMCU, Utrecht, The Netherlands
F. D. Houghton
Affiliation:
Centre for Human Development, Stem Cells and Regeneration, Faculty of Medicine, University of Southampton, Southampton, UK Human Development and Health Academic Unit, Faculty of Medicine, University of Southampton, Southampton, UK
P. C. Calder
Affiliation:
Human Development and Health Academic Unit, Faculty of Medicine, University of Southampton, Southampton, UK NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust and University of Southampton, Southampton, UK
I. T. Cameron
Affiliation:
Human Development and Health Academic Unit, Faculty of Medicine, University of Southampton, Southampton, UK NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust and University of Southampton, Southampton, UK
N. S. Macklon*
Affiliation:
Human Development and Health Academic Unit, Faculty of Medicine, University of Southampton, Southampton, UK NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust and University of Southampton, Southampton, UK Department of Obstetrics and Gynaecology, Complete Fertility Centre, Princess Anne Hospital, Southampton, UK
*
*Address for correspondence: Professor N. S. Macklon, Department of Obstetrics and Gynaecology (MP815), Princess Anne Hospital, University of Southampton, Coxford Road, Southampton, SO16 5YA, UK. (Email [email protected])
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Abstract

The recognition of ‘fetal origins of adult disease’ has placed new responsibilities on the obstetrician, as antenatal care is no longer simply about ensuring good perinatal outcomes, but also needs to plan for optimal long-term health for mother and baby. Recently, it has become clear that the intrauterine environment has a broad and long-lasting impact, influencing fetal and childhood growth and development as well as future cardiovascular health, non-communicable disease risk and fertility. This article looks specifically at the importance of the developmental origins of ovarian reserve and ageing, the role of the placenta and maternal nutrition before and during pregnancy. It also reviews recent insights in developmental medicine of relevance to the obstetrician, and outlines emerging evidence supporting a proactive clinical approach to optimizing periconceptional as well as antenatal care aimed to protect newborns against long-term disease susceptibility.

Keywords

developmental originsovaryplacentapregnancy
Type
Review
Information
Journal of Developmental Origins of Health and Disease , Volume 6 , Issue 5: Themed Issue: David Barker commemorative meeting, September 2014; Prenatal Exposures and Health Outcomes , October 2015 , pp. 415 - 424
Copyright
© Cambridge University Press and the International Society for Developmental Origins of Health and Disease 2015 

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