Fetal nutrition and cardiovascular disease in adult life
Open accessAbstract
Babies who are small at birth or during infancy have increased rates of cardiovascular disease and non-insulin-dependent diabetes as adults. Some of these babies have low birthweights, some are small in relation to the size of their placentas, some are thin at birth, and some are short at birth and fail to gain weight in infancy. This paper shows how fetal undernutrition at different stages of gestation can be linked to these patterns of early growth. The fetuses' adaptations to undernutrition are associated with changes in the concentrations of fetal and placental hormones. Persisting changes in the levels of hormone secretion, and in the sensitivity of tissues to them, may link fetal undernutrition with abnormal structure, function, and disease in adult life.
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Barker's foundational work identified associations between undernutrition during gestation, low birth weight and higher rates of ischemic heart and coronary artery disease mortality in adulthood in British children born in the 1920s.
“Barker’s foundational work identified associations between undernutrition during gestation, low birth weight and higher rates of ischemic heart and coronary artery disease mortality in adulthood in British children born in the 1920s [38,39,40,41].”
From Recent Experimental Studies of Maternal Obesity, Diabetes during Pregnancy and the Developmental Origins of Cardiovascular Disease (2022) · cites this paper as [41]
The DOHaD theory proposed that nutrient restriction during specific periods of development influences susceptibility for cardiovascular and metabolic diseases in adulthood.
“Thus, the DOHaD theory proposed that nutrient restriction during specific periods of development (e.g., conception, gestation and the first few years of life), when tissues and organs are particularly sensitive to environmental exposures, as a consequence influence the susceptibility for cardiovascular and metabolic diseases in adulthood [41,42,43].”
From Recent Experimental Studies of Maternal Obesity, Diabetes during Pregnancy and the Developmental Origins of Cardiovascular Disease (2022) · cites this paper as [41]
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Leunissen, R. W. J. (2009) · JAMA · doi:10.1001/jama.2009.761 · Cited by 508 · see citing works
Fetal and Childhood Growth and Hypertension in Adult Life
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Self-citationIntrauterine growth restriction: new concepts in antenatal surveillance, diagnosis, and management
Figueras, F., & Gardosi, J. (2011) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2010.08.055 · Cited by 485 · see citing works
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Angiogenic Factors and Preeclampsia
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Developmental programming of obesity in mammals
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The Fetal Matrix: Evolution, Development and Disease
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Self-citationFetal and infant growth and cardiovascular risk factors in women
Fall, C. H. D., Osmond, C., Barker, D. J., Clark, P. M., Hales, C. N., Stirling, Y., & Meade, T. W. (1995) · BMJ · doi:10.1136/bmj.310.6977.428 · Cited by 461 · see citing works
Self-citationGene expression patterns in human placenta
Sood, R., Zehnder, J. L., Druzin, M. L., & Brown, P. O. (2006) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.0508035103 · Cited by 454 · see citing works
Fetal undernutrition and disease in later life
Barker, D. (1997) · Reviews of Reproduction · doi:10.1530/ror.0.0020105 · Cited by 457 · see citing works
Self-citationMother's weight in pregnancy and coronary heart disease in a cohort of finnish men: follow up study
Forsén, T., Eriksson, J. G., Tuomilehto, J. O., Teramo, K., Osmond, C., & Barker, D. J. P. (1997) · BMJ · doi:10.1136/bmj.315.7112.837 · Cited by 452 · see citing works
Self-citationPathological aspects of lipid peroxidation
Nègre‐Salvayre, A., Augè, N., Ayala, V., Başağa, H., Boada, J., Brenke, R., Chapple, S. J., Cohen, G., Fehér, J., Grune, T., et al. (2010) · Free Radical Research · doi:10.3109/10715762.2010.498478 · Cited by 451 · see citing works
Assessment of Fetal Compromise by Doppler Ultrasound Investigation of the Fetal Circulation
Hecher, K., Campbell, S. C., Doyle, P., Harrington, K., & Nicolaides, K. H. (1995) · Circulation · doi:10.1161/01.cir.91.1.129 · Cited by 444 · see citing works
Andrew, T., Hart, D. J., Snieder, H., de Lange, M., Spector, T. D., & MacGregor, A. J. (2001) · Twin Research · doi:10.1375/1369052012803 · Cited by 440 · see citing works
Intrauterine programming of adult disease
Barker, D. J. P. (1995) · Molecular Medicine Today · doi:10.1016/s1357-4310(95)90793-9 · Cited by 434 · see citing works
Self-citationDrake, A. J., & Walker, B. (2004) · Journal of Endocrinology · doi:10.1677/joe.0.1800001 · Cited by 430 · see citing works
Fetal origins of cardiovascular disease
Barker, D. J. P. (1999) · Annals of Medicine · doi:10.1080/07853890.1999.11904392 · Cited by 426 · see citing works
Self-citationLangley‐Evans, S. C., Phillips, G. J., Benediktsson, R., Gardner, D. S., Edwards, C. R. W., Jackson, A. A., & Seckl, J. R. (1996) · Placenta · doi:10.1016/s0143-4004(96)80010-5 · Cited by 415 · see citing works
Premature Adrenarche--Normal Variant or Forerunner of Adult Disease?
Ibáñez, L., DiMartino-Nardi, J., Potau, N., & Saenger, P. H. (2000) · Endocrine Reviews · doi:10.1210/edrv.21.6.0416 · Cited by 414 · see citing works
In utero programming of cardiovascular disease
Barker, D. J. P. (2000) · Theriogenology · doi:10.1016/s0093-691x(99)00258-7 · Cited by 406 · see citing works
Self-citationMaternal stress alters endocrine function of the feto-placental unit in rats
Mairesse, J., Lesage, J., Breton, C., Bréant, B., Hahn, T., Darnaudéry, M., Dickson, S. L., Seckl, J., Blondeau, B., Vieau, D., et al. (2007) · American Journal of Physiology-Endocrinology and Metabolism · doi:10.1152/ajpendo.00574.2006 · Cited by 410 · see citing works
Intergenerational consequences of fetal programming by in utero exposure to glucocorticoids in rats
Drake, A. J., Walker, B. R., & Seckl, J. R. (2004) · American Journal of Physiology-Regulatory, Integrative and Comparative Physiology · doi:10.1152/ajpregu.00106.2004 · Cited by 409 · see citing works
Childhood growth, physical activity, and peak bone mass in women
Cooper, C. C., Cawley, M., Bhalla, A. K., Egger, P., Ring, F. J., Morton, L. A., & Barker, D. J. (1995) · Journal of Bone and Mineral Research · doi:10.1002/jbmr.5650100615 · Cited by 408 · see citing works
Self-citationWhy Are Indian Children So Short? The Role of Birth Order and Son Preference
Jayachandran, S., & Pande, R. (2017) · American Economic Review · doi:10.1257/aer.20151282 · Cited by 406 · see citing works
Li, X., Huang, S., Jiao, A., Yang, X., Yun, J., Wang, Y., Xue, X., Chu, Y., Liu, F., Liu, Y., et al. (2017) · Environmental Pollution · doi:10.1016/j.envpol.2017.03.055 · Cited by 395 · see citing works
Glucocorticoid programming of the fetus; adult phenotypes and molecular mechanisms
Seckl, J. R. (2001) · Molecular and Cellular Endocrinology · doi:10.1016/s0303-7207(01)00633-5 · Cited by 392 · see citing works
Léger, J., Lévy‐Marchal, C., Bloch, J., Pinet, A., Chevenne, D., Porquet, D., Collin, D., & Czernichow, P. (1997) · BMJ · doi:10.1136/bmj.315.7104.341 · Cited by 389 · see citing works
Martyn, C., Barker, D., & Osmond, C. (1996) · The Lancet · doi:10.1016/s0140-6736(96)04257-2 · Cited by 381 · see citing works
Self-citationLésage, J., Blondeau, B., Grino, M., Bréant, B., & Dupouy, J. (2001) · Endocrinology · doi:10.1210/endo.142.5.8139 · Cited by 380 · see citing works
Leeson, C. P. M., Kattenhorn, M., Morley, R., Lucas, A., & Deanfield, J. E. (2001) · Circulation · doi:10.1161/01.cir.103.9.1264 · Cited by 379 · see citing works
Fetal nutrition and cardiovascular disease in later life
Barker, D. J. P. (1997) · British Medical Bulletin · doi:10.1093/oxfordjournals.bmb.a011609 · Cited by 373 · see citing works
Self-citationCooper, J. B. M. B. C. F. C. O. C. (2013) · BMJ · doi:10.1136/bmj.f5703 · Cited by 373 · see citing works
Woodall, S., Johnston, B. M., Breier, B. H., & Gluckman, P. D. (1996) · Pediatric Research · doi:10.1203/00006450-199609000-00012 · Cited by 372 · see citing works
Self-citationProgramming of lean body mass: a link between birth weight, obesity, and cardiovascular disease?
Singhal, A., Wells, J. C. K., Cole, T. J., Fewtrell, M. S., & Lucas, A. (2003) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/77.3.726 · Cited by 372 · see citing works
U.S. Health in International Perspective: Shorter Lives, Poorer Health
(2016) · Military Medicine · doi:10.7205/milmed-d-16-00227 · Cited by 372 · see citing works
Gender-linked hypertension in offspring of lard-fed pregnant rats
Khan, I. Y., Taylor, P. D., Dekou, V., Seed, P. T., Lakasing, L., Graham, D., Dominiczak, A. F., Hanson, M. A., & Poston, L. (2003) · Hypertension · doi:10.1161/01.hyp.0000047511.97879.fc · Cited by 365 · see citing works
Fetal Growth and Maternal Exposure to Particulate Matter during Pregnancy
Dejmek, J., Selevan, S. G., Beneš, I., Solanský, I., & Šrám, R. J. (1999) · Environmental Health Perspectives · doi:10.1289/ehp.99107475 · Cited by 362 · see citing works
Growth in utero, adult blood pressure, and arterial compliance.
Martyn, C. N., Barker, D. J. P., Jespersen, S., Greenwald, S. E., Osmond, C., & Berry, C. L. (1995) · Heart · doi:10.1136/hrt.73.2.116 · Cited by 362 · see citing works
Self-citationvan Dijk, S. J., Molloy, P. L., Varinli, H., Morrison, J. L., Mühlhäusler, B. S., EpiSCOPE, M. O., Buckley, M. J., Clark, S. J., McMillen, I. C., Noakes, M., et al. (2014) · International Journal of Obesity · doi:10.1038/ijo.2014.34 · Cited by 358 · see citing works
The Effect of Maternal Stress on Birth Outcomes: Exploiting a Natural Experiment
Torche, F. (2011) · Demography · doi:10.1007/s13524-011-0054-z · Cited by 346 · see citing works
Ritz, B. R., Yu, F., Chapa, G., & Fruin, S. A. (2000) · Epidemiology · doi:10.1097/00001648-200009000-00004 · Cited by 348 · see citing works
Vickers, M. H., Breier, B. H., McCarthy, D., & Gluckman, P. D. (2003) · American Journal of Physiology-Regulatory, Integrative and Comparative Physiology · doi:10.1152/ajpregu.00051.2003 · Cited by 346 · see citing works
Self-citationGrowth in infancy and bone mass in later life
Cooper, C. C., Fall, C. H. D., Egger, P., Hobbs, R. F., Eastell, R., & Barker, D. J. (1997) · Annals of the Rheumatic Diseases · doi:10.1136/ard.56.1.17 · Cited by 346 · see citing works
Self-citationKlepac, P., Locatelli, I., Korošec, S., Künzli, N., & Kukec, A. (2018) · Environmental Research · doi:10.1016/j.envres.2018.07.008 · Cited by 345 · see citing works
Diet in pregnancy and the offspring's blood pressure 40 years later
Campbell, D. M., Hall, M. H., Barker, D. J. P., Cross, J. F., Shiell, A. W., & Godfrey, K. M. (1996) · BJOG An International Journal of Obstetrics & Gynaecology · doi:10.1111/j.1471-0528.1996.tb09718.x · Cited by 344 · see citing works
Self-citationRoutine ultrasound in late pregnancy (after 24 weeks' gestation)
Bricker, L., Medley, N., & Pratt, J. J. (2015) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd001451.pub4 · Cited by 337 · see citing works
Amuna, P., & Zotor, F. B. (2008) · Proceedings of The Nutrition Society · doi:10.1017/s0029665108006058 · Cited by 336 · see citing works
Gestational Age at Birth and Mortality in Young Adulthood
Crump, C., Sundquist, K., Sundquist, J., & Winkleby, M. A. (2011) · JAMA · doi:10.1001/jama.2011.1331 · Cited by 330 · see citing works
- Authors
- Barker, D. J. P., Godfrey, K. M., Gluckman, P. D., Harding, J. E., Owens, J. A., & Robinson, J. S.
- Affiliations
- Southampton General Hospital (GB)
- University of Auckland (NZ)
- The University of Adelaide (AU)
- Venue
- The Lancet
- Publisher
- Elsevier BV
- Published
- 1993-04
- Volume
- 341
- Issue
- 8850
- Pages
- 938-941
- ISSN
- 0099-5355 (ISSN-L)
- 0140-6736
- OpenAlex
- W2096601431
- Cited by
- 2,753
- References
- 53
- Citations by year
- 2026: 39 · 2025: 47 · 2024: 68 · 2023: 81 · 2022: 108 · 2021: 103 · 2020: 113 · 2019: 98 · 2018: 142 · 2017: 121 · 2016: 111 · 2015: 115 · 2014: 126 · 2013: 100 · 2012: 107
- FWCI
- 14.76
- Type
- journal article
- Language
- en
- Open access
- green
- figshare.com
- Licence
- Locations
- The Lancet (publishedVersion)
- PubMed (publishedVersion)
- Figshare (submittedVersion, cc-by)
- Topics
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Birth, Development, and Health
- Health Sciences › Medicine › Obstetrics and Gynecology › Pregnancy and preeclampsia studies
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Prenatal Substance Exposure Effects
- Keywords
- fetal malnutrition, fetal programming, cardiovascular disease, type 2 diabetes, low birth weight, small for gestational age, placental hormones, fetal growth, developmental origins of health and disease, hormone sensitivity
- MeSH terms
- Adult, Birth Weight, Body Height, Cardiovascular Diseases, Diabetes Mellitus, Type 2, Female, Fetal Growth Retardation, Humans, Hydrocortisone, Infant Nutrition Disorders, Infant, Low Birth Weight, Infant, Newborn, Infant, Small for Gestational Age, Insulin, Insulin Resistance, Insulin-Like Growth Factor I, Male, Nutrition Disorders, Pregnancy, Pregnancy Complications, Risk Factors
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