Cited by 1,147Birth, Development, and HealthPrenatal Substance Exposure EffectsGestational Diabetes Research and Management

Origins of lifetime health around the time of conception: causes and consequences

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Fleming, Tom P, Watkins, Adam J, Velazquez, Miguel A, Mathers, John C, Prentice, Andrew M, Stephenson, Judith, Barker, Mary, Saffery, Richard +6 more·2018·The Lancet

Abstract

Parental environmental factors, including diet, body composition, metabolism, and stress, affect the health and chronic disease risk of people throughout their lives, as captured in the Developmental Origins of Health and Disease concept. Research across the epidemiological, clinical, and basic science fields has identified the period around conception as being crucial for the processes mediating parental influences on the health of the next generation. During this time, from the maturation of gametes through to early embryonic development, parental lifestyle can adversely influence long-term risks of offspring cardiovascular, metabolic, immune, and neurological morbidities, often termed developmental programming. We review periconceptional induction of disease risk from four broad exposures: maternal overnutrition and obesity; maternal undernutrition; related paternal factors; and the use of assisted reproductive treatment. Studies in both humans and animal models have demonstrated the underlying biological mechanisms, including epigenetic, cellular, physiological, and metabolic processes. We also present a meta-analysis of mouse paternal and maternal protein undernutrition that suggests distinct parental periconceptional contributions to postnatal outcomes. We propose that the evidence for periconceptional effects on lifetime health is now so compelling that it calls for new guidance on parental preparation for pregnancy, beginning before conception, to protect the health of offspring.

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  • These processes are vulnerable to disturbance of epigenetic mechanisms, leading to an altered profile of embryonic gene expression that persists throughout both pregnancy and childhood.

    “These processes are vulnerable to disturbance of epigenetic mechanisms, leading to an altered profile of embryonic gene expression that persists throughout both pregnancy and childhood [9].”

    From Associations between periconceptional lifestyle behaviours and adverse pregnancy outcomes (2021) · cites this paper as [9]

    The Periconceptional developmental programming and ART section says embryo culture can alter gene expression and epigenetic patterns, and that ART-induced epigenetic profiles may persist through pregnancy into childhood. But it does not establish that an altered profile of embryonic gene expression itself persists for that period. The Diversity and commonality subsection cautions that epigenetic changes are not necessarily linked directly to changes in gene expression. (LLM, conf=0.88)

    Experimental — accuracy not yet measured
  • The risk of developing chronic inflammation can be traced to early development, and its effects persist across the life span to influence adult health and mortality risk.

    “Evidence is emerging that the risk of developing chronic inflammation can be traced back to early development, and its effects are now known to persist throughout the life span to affect adulthood health and risk of mortality6–8.”
  • Systemic chronic inflammation during pregnancy and childhood can elevate the risk of non-communicable diseases across the life span.

    “SCI during pregnancy and childhood can have serious developmental consequences that include elevating the risk of non-communicable diseases over the life span7,8,26,27.”

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  1. [98]Hanson M Godfrey K Poston L Bustreo F Stephenson J Preconception health Annual Report of the Chief Medical Officer 2014, The Health of the 51%: Women Davies SC London Department of Health 2015 53 66 Chapter 5

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Authors
Fleming, T. P., Watkins, A. J., Velazquez, M. A., Mathers, J. C., Prentice, A. M., Stephenson, J., Barker, M., Saffery, R., Yajnik, C. S., Eckert, J. J., Hanson, M. A., Forrester, T., Gluckman, P. D., & Godfrey, K. M.
Affiliations
  • University of Southampton (GB)
  • University of Nottingham (GB)
  • Newcastle University (GB)
  • London School of Hygiene & Tropical Medicine (GB)
  • University College London (GB)
  • University Hospital Southampton NHS Foundation Trust (GB)
  • The University of Melbourne (AU)
  • University of the West Indies (JM)
  • Agency for Science, Technology and Research (SG)
Corresponding author
Godfrey, Keith M
Venue
The Lancet
Publisher
Elsevier BV
Published
2018-05
Volume
391
Issue
10132
Pages
1842-1852
ISSN
  • 0099-5355 (ISSN-L)
  • 0140-6736
OpenAlex
W2787931223
Cited by
1,147
References
99
Citations by year
2026: 117 · 2025: 127 · 2024: 129 · 2023: 132 · 2022: 168 · 2021: 137 · 2020: 170 · 2019: 131 · 2018: 35
FWCI
22.60
Type
journal article
Language
en
Open access
Locations
  • The Lancet (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
  • ePrints Soton (University of Southampton) (acceptedVersion)
  • UCL Discovery (University College London) (submittedVersion)
  • Repository@Nottingham (University of Nottingham) (submittedVersion, cc-by)
Funders
  • Medical Research Council (MC_UU_12011/4, MC-A760-5QX00)
  • State Government of Victoria
  • Aston University
  • Nestlé Nutrition Institute
  • Rosetrees Trust
  • National Institute for Health Research (NF-SI-0515-10042)
  • Seventh Framework Programme (317146, 278418, FP7/2007-2013)
  • British Heart Foundation
  • Department for International Development, UK Government
  • Biotechnology and Biological Sciences Research Council (BB/1001840/1, BB/F007450/1)
Topics
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Birth, Development, and Health
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Prenatal Substance Exposure Effects
  • Health Sciences › Medicine › Obstetrics and Gynecology › Gestational Diabetes Research and Management
Keywords
periconceptional period, developmental origins of health and disease, developmental programming, maternal overnutrition, maternal obesity, maternal undernutrition, paternal factors, assisted reproduction, epigenetics, gamete maturation, embryonic development, offspring cardiovascular risk, metabolic risk, neurological risk, preconception health, protein malnutrition
MeSH terms
Animals, Diet, Female, Fertilization, Humans, Obesity, Pregnancy, Prenatal Exposure Delayed Effects, Prenatal Nutritional Physiological Phenomena, Epigenesis, Genetic, Embryonic Development, Mice

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