The Role of the Placenta in Fetal Programming—A Review
Abstract
The fetal origins hypothesis proposes that adult cardiovascular and metabolic disease originate through developmental plasticity and fetal adaptations arising from failure of the materno-placental supply of nutrients to match fetal requirements. The hypothesis is supported by experimental data in animals indicating that maternal nutrition can programme long term effects on the offspring without necessarily affecting size at birth. There is now evidence linking body composition in pregnant women and the balance of nutrient intake during pregnancy with raised levels of cardiovascular risk factors in the offspring. Maternal body composition and diet are thought to affect fetal development and programming as a result of both direct effects on substrate availability to the fetus and indirectly through changes in placental function and structure. Alterations in placental growth and vascular resistance, altered nutrient and hormone metabolism in the placenta, and changes in nutrient transfer and partitioning between mother, placenta and fetus all have important effects on the fetal adaptations thought to be central to programming. Future interventions to improve placental function are likely to have lifelong health benefits for the offspring.
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The risk of cardiovascular disease in adult men in relation to the birth weight to placental weight ratio is U-shaped, with heart-related death rates lowest when placental weight is about 19% of birth weight.
“The risk of cardiovascular disease in adult men in relation to the birth weight to placental weight ratio does not follow a linear fashion as one might expect, but rather a “U” shaped pattern with heart-related death rates being lowest when placental weight is ~19% of birth weight (Figure 5) (25, 217, 361).”
From Placental Origins of Chronic Disease (2016) · cites this paper as [217]
The lowest rates of death from heart disease were found among men where the placental weight was approximately 19% of the newborn body weight.
“The lowest rates of death from heart disease were found among men where the placental weight was approximately 19% of the newborn body weight.”
From Placental Origins of Chronic Disease (2016) · cites this paper as [217]
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References 82 · Cited by 305
- Authors
- Godfrey, K. M.
- Affiliations
- Southampton General Hospital (GB)
- Corresponding author
- Godfrey, Keith M.
- ORCID
- Godfrey, Keith M.
- Venue
- Placenta
- Publisher
- Elsevier BV
- Published
- 2002-04
- Volume
- 23
- Pages
- S20-S27
- ISSN
- 0143-4004 (ISSN-L)
- OpenAlex
- W2119437828
- Cited by
- 305
- References
- 82
- Citations by year
- 2026: 5 · 2025: 9 · 2024: 12 · 2023: 11 · 2022: 13 · 2021: 11 · 2020: 6 · 2019: 16 · 2018: 16 · 2017: 14 · 2016: 15 · 2015: 24 · 2014: 13 · 2013: 16 · 2012: 22
- FWCI
- 6.01
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Placenta (publishedVersion)
- PubMed (publishedVersion)
- ePrints Soton (University of Southampton) (submittedVersion)
- 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 › Obstetrics and Gynecology › Gestational Diabetes Research and Management
- Keywords
- fetal programming, fetal origins hypothesis, developmental plasticity, maternal nutrition, maternal body composition, cardiovascular disease, metabolic disorders, placental function, placental vascular resistance, nutrient transfer
- MeSH terms
- Adaptation, Physiological, Adult, Animals, Birth Weight, Cardiovascular Diseases, Female, Embryonic and Fetal Development, Humans, Male, Maternal-Fetal Exchange, Metabolic Diseases, Nutrition Disorders, Organ Size, Placenta, Pregnancy, Pregnancy Complications, Prenatal Exposure Delayed Effects
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