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Midwifery Approach to Lifestyle Medicine for Reproductive Health
Published in Gia Merlo, Kathy Berra, Lifestyle Nursing, 2023
Developing and fostering habits in the preconception period that help ensure a healthy way of life through the critical periods of conception and the first trimester is crucial for appropriate placental, embryonic, and fetal development. A number of observational studies link health before pregnancy with long-term outcomes extending to future generations, in addition to pregnancy and birth outcomes (Stephenson et al., 2018). Research in the area of epigenetics and “fetal programming” suggests an association between obesity, poor nutrition, and unhealthy lifestyle during the preconception period (Kudesia et al., 2021) and long-term risk of cardiovascular disease in offspring (Steegers, 2014).
Fetal programming
Published in Hung N. Winn, Frank A. Chervenak, Roberto Romero, Clinical Maternal-Fetal Medicine Online, 2021
Katherine E. Pelch, Jana L. Allison, Susan C. Nagel
The prenatal period requires vigilance to insure a safe environment for the fetus to grow and develop appropriately. Great lengths are taken during prenatal care to avoid exposures known to have teratogenic potential. Fetal programming is the theory that environmental events in utero during sensitive windows of development can have permanent and long-lasting effects. The fetus has the capacity for developmental plasticity. That is, one genotype can lead to different phenotypes depending on environmental factors (1). In other words, the environment interacts with genes in the developing organism to permanently program gene expression in adulthood. Changes in the fetal environment can program childhood and adult response pathways. Therefore, the developmental period represents a critical opportunity for irreversible effects from the fetal environment, whether these are from pharmaceuticals, nutrition, microorganisms, the maternal hormonal milieu, and/or environmental chemicals.
Stress and Parenting
Published in Marc H. Bornstein, Psychological Insights for Understanding COVID-19 and Families, Parents, and Children, 2020
Keith A. Crnic, Shayna S. Coburn
There is some research that explores these potential physiological mechanisms and sheds light on the psychobiological mechanism involved in parenting stress. One area of interest has been maternal prenatal stress and related fetal programming hypotheses. Neuenschwander and Oberlander (2017) noted that “the period of intrauterine life represents one of the most sensitive windows during which the effects may be transmitted inter-generationally from a mother to her as yet unborn child” (p. 127). Risk can be conferred prenatally through changes in maternal mood-related physiology that then influence fetal neurobehavioral development, later maternal depression, and negative parenting during infancy (Belsky, Ruttle, Boyce, Armstrong, and Essex, 2015). The HPA axis plays a critical role in mediating the effects of maternal prenatal stress on child functioning, and fetal programming represents a potential mechanism of effect through which maternal stress experience and physiology affect children’s development. Findings regarding fetal programming have been variable to date, but indications suggest that maternal prenatal stress is associated with increased reactivity in cortisol during infancy and middle childhood (Neuenschwander and Oberlander, 2017) as well as with regulatory development in early infancy (Lin et al., 2014). There is also evidence to support a connection between maternal prenatal stress and child prefrontal cortex development and executive function in middle school years (Buss, Davis, Hobel, and Sandman, 2011).
Association between hypertensive disorders of pregnancy and risk of attention-deficit/hyperactivity disorder in the offspring: a systematic review and meta-analysis
Published in Hypertension in Pregnancy, 2022
The mechanism by which HDP increases the risk of ADHD is still unclear. O’Donnell et al. (34) have proposed the fetal programming theory suggesting that unfavorable fetal environment or insult influences brain development resulting in a variety of neurodevelopmental disorders. HDP could also result in depleted fetal oxygen and nutrient supply causing uteroplacental under perfusion and hypoxia, which in turn could increase the risk of neurological disorders later in life (35,36). Early-onset pre-eclampsia affects placental development and the defective placenta could also contribute to a heightened risk of neurodevelopmental disorders (34). Research also suggests that preterm birth and low birth weight resulting from pre-eclampsia are important contributors to mental disorders in the offspring (32). More recently, inflammation and oxidative stress, which are commonly seen in patients with pre-eclampsia, have been implicated in the risk of childhood neurodevelopmental disorders. It is postulated that inflammation of the maternal, placental and fetal circulatory system results in prenatal exposure to pro-inflammatory cytokines, which increase the risk of neurodevelopmental disorders. Increased oxidative stress in intrauterine life induced the placenta to secrete factors that are injurious to fetal neurons resulting in defective neurodevelopment (37).
Testing the Institute of Medicine (IOM) recommendations on maternal reproductive health and associated neonatal characteristics in a transitional, Mediterranean population
Published in Annals of Human Biology, 2022
Jelena Šarac, Dubravka Havaš Auguštin, Matea Zajc Petranović, Natalija Novokmet, Luka Bočkor, Lada Stanišić, Emily Petherick, Deni Karelović, Alen Šelović, Rafaela Mrdjen Hodžić, Sanja Musić Milanović, Ellen W. Demerath, Lawrence M. Schell, Noël Cameron, Saša Missoni
There are a growing number of studies showing that high maternal pre-pregnancy BMI and inadequate or excessive gestational weight gain (GWG) are significant risk factors for mother’s health during pregnancy and many adverse birth outcomes (Siega-Riz et al. 2009; Goldstein et al. 2017). Poor conditions in the intrauterine environment, caused by physiological and metabolic changes associated with maternal obesity, gestational diabetes, or malnutrition during pregnancy influence foetal programming and can have long-term adverse effects on the child’s health later in life (Van De Maele et al. 2018). Besides being susceptible to gestational hypertension, preeclampsia, and gestational diabetes, pregnant women who are overweight and obese have higher rates of caesarean births (Chu et al. 2007), and newborns born to mothers with obesity and overweight are more likely to be large for gestational age (LGA) than those from appropriate-weight mothers, and can have adverse health outcomes later in life (Gaudet et al. 2014; Rogozińska et al. 2019).
Prenatal stress and increased susceptibility to anxiety-like behaviors: role of neuroinflammation and balance between GABAergic and glutamatergic transmission
Published in Stress, 2021
Shiva Roshan-Milani, Behdad Seyyedabadi, Ehsan Saboory, Negin Parsamanesh, Nasrin Mehranfard
The stress experienced by a mother before giving birth is called prenatal stress (PS). PS can exert early and long-lasting effects on neurobehavioral development in both human and animal offspring (Ahmadzadeh et al., 2011; Edwards et al., 2002; Gholipoor et al., 2017; Kofman, 2002). It decreases learning and memory ability and increases attention deficiency, seizure susceptibility, behavioral abnormalities, and anxiety (Coe et al., 2003; Fride & Weinstock, 1988; Glover, 2011; Hashemi et al., 2013, 2016; Heshmatian et al., 2010; Mahmoodkhani et al., 2018; Saboory et al., 2015, 2019; Takahashi, 1992; Tollenaar et al., 2011; van den Bergh et al., 2018). These effects have been attributed to various mechanisms, most of which are related to the concept of fetal programming (Entringer et al., 2012). The fetal programming model suggests that the fetus phenotype can change during the prenatal period in accordance with changes in the fetal environment, such as stress exposure (Ensminger et al., 2018). However, not all infants show developmental problems due to such exposure (Dipietro, 2004). Factors such as the timing, intensity, duration, and type of exposure may partly explain some of these individual differences in early childhood behavior (Boersma & Tamashiro, 2015;; Del Giudice, 2016).