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The developmental origins of chronic adult disease
Abstract
Low birthweight is now known to be associated with increased rates of coronary heart disease and the related disorders stroke, hypertension and non-insulin-dependent diabetes. These associations have been extensively replicated in studies in different countries and are not the result of confounding variables. They extend across the normal range of birthweight and depend on lower birthweights in relation to the duration of gestation rather than the effects of premature birth. The associations are thought to be consequences of developmental plasticity, the phenomenon by which one genotype can give rise to a range of different physiological or morphological states in response to different environmental conditions during development. Recent observations have shown that impaired growth in infancy and rapid childhood weight gain exacerbate the effects of impaired prenatal growth. Coronary heart disease and the disorders related to it arise through a series of interactions between environmental influences and the pathways of development that preceded them. These diseases are the product of branching pathways of development in which the branchings are triggered by the environment before and after birth.
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“FGR is associated with significant perinatal morbidity and mortality (3) and babies with FGR can be predisposed to metabolic diseases later in life (4).”
BackgroundArnott, G., Roberts, D. J., Rooke, J. A., Turner, S. P., Lawrence, A. B., & Rutherford, K. (2012) · Journal of Animal Science · doi:10.2527/jas.2012-5463 · Cited by 52
Maturana, C. J., Aguirre, A., & Sáez, J. C. (2016) · Developmental Neurobiology · doi:10.1002/dneu.22409 · Cited by 51
Irwin, R. E., Thursby, S.-J., Ondičová, M., Pentieva, K. D., McNulty, H., Richmond, R. C., Caffrey, A., Lees‐Murdock, D. J., McLaughlin, M., Cassidy, T., et al. (2019) · Clinical Epigenetics · doi:10.1186/s13148-019-0618-0 · Cited by 53
“it can also affect phenotype and predisposition to childhood and adulthood disease [41].”
BackgroundLaitinen, K., Hoppu, U., Hämäläinen, M., Linderborg, K. M., Moilanen, E., & Isolauri, E. (2006) · Pediatric Research · doi:10.1203/01.pdr.0000203158.31452.9e · Cited by 52
“The accumulating data point to the early fetal period and infancy as the critical phase (1).”
BackgroundVargas-Martínez, F., Uvnäs-Moberg, K., Petersson, M., Olausson, H. A., & Jiménez-Estrada, I. (2014) · Progress in Neurobiology · doi:10.1016/j.pneurobio.2014.10.001 · Cited by 51
Bluett‐Duncan, M., Kishore, M. T., Patil, D. M., Satyanarayana, V. A., & Sharp, H. M. (2021) · PLoS ONE · doi:10.1371/journal.pone.0253790 · Cited by 54
Maternal asthma and microRNA regulation of soluble HLA-G in the airway
Nicodemus‐Johnson, J., Laxman, B., Stern, R. K., Sudi, J., Tierney, C. N., Norwick, L. M., Hogarth, D. K., McConville, J. F., Naureckas, E. T., Sperling, A. I., et al. (2013) · Journal of Allergy and Clinical Immunology · doi:10.1016/j.jaci.2013.01.037 · Cited by 50
Gallagher, D., Rosenn, B., Toro‐Ramos, T., Paley, C., Gidwani, S., Horowitz, M., Crane, J., Lin, S. X., Thornton, J. C., & Pi-Sunyer, X. (2018) · Obesity · doi:10.1002/oby.22079 · Cited by 56
“of developing obesity and related cardiometabolic diseases (1,2).”
Utero-placental Doppler ultrasound for improving pregnancy outcome
Stampalija, T., Alfirević, Ž., & Gyte, G. M. (2010) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd008363 · Cited by 50
Kupffer cell programming by maternal obesity triggers fatty liver disease
Huang, H., Balzer, N. R., Seep, L., Šplíchalová, I., Blank-Stein, N., Viola, M. F., Taveras, E. F., Acil, K., Fink, D., Petrovic, F., et al. (2025) · Nature · doi:10.1038/s41586-025-09190-w · Cited by 52
Fetal-Derived Immune Cells at the Roots of Lifelong Pathophysiology
Mass, E., & Gentek, R. (2021) · Frontiers in Cell and Developmental Biology · doi:10.3389/fcell.2021.648313 · Cited by 47
“Developmental Programming of EMP-Derived Cells by Adverse Early Life Environments It is now firmly established that the likelihood of developing a non-communicable disease in adulthood is strongly influenced by environmental factors in early life, including the fetal period (Barker, 2004).”
BackgroundPrenatal Exposure to Nonpersistent Chemical Mixtures and Fetal Growth: A Population-Based Study
van den Dries, M. A., Keil, A. P., Tiemeier, H. W., Pronk, A., Spaan, S., Santos, S., Asimakopoulos, A. G., Kannan, K., Gaillard, R., Guxens, M., et al. (2021) · Environmental Health Perspectives · doi:10.1289/ehp9178 · Cited by 49
Effect of maternal food restriction on fetal rat lung lipid differentiation program
Karadag, A., Sakurai, R., Wang, Y., Guo, P., Desai, M., Ross, M. G., Torday, J. S., & Rehan, V. K. (2009) · Pediatric Pulmonology · doi:10.1002/ppul.21030 · Cited by 49
Neuropharmacology of drugs and alcohol in mother and fetus
Pollard, I. (2007) · Seminars in Fetal and Neonatal Medicine · doi:10.1016/j.siny.2006.12.001 · Cited by 49
“Much has been learned since David Barker and colleagues first proposed that suboptimal intrauterine growth might alter fetal development in ways that predispose the offspring to a range of diseases in adulthood.(19) As nutrition directly or indirectly influences epigenetic processes that fine-tune DNA function, the nu…”
InfluentialThe influence of industry-related air pollution on birth outcomes in an industrialized area
Bergstra, A. D., Brunekreef, B., & Burdorf, A. (2020) · Environmental Pollution · doi:10.1016/j.envpol.2020.115741 · Cited by 48
“In addition, effects of LBW on coronary heart disease and the related disorders stroke, hypertension and non-insulin-dependent diabetes during later-life have been observed (Barker, 2004).”
BackgroundRazak, N. A., Shariff, Z. M., Taib, M. N. M., Gan, W. Y., & Tan, K. (2016) · BMC Pediatrics · doi:10.1186/s12887-016-0700-0 · Cited by 47
“For example, an undernourished mother during pregnancy will send a signal to her fetus that the environment outside might be harsh and the fetus will respond to this signal by reducing body size and altering metabolism for survival after birth [3].”
BackgroundEnvironmental lead exposure, maternal thyroid function, and childhood growth
Lamb, M. R., Janevic, T. M., Liu, X., Cooper, T. B., Kline, J. K., & Factor-Litvak, P. R. (2007) · Environmental Research · doi:10.1016/j.envres.2007.09.012 · Cited by 46
Andersen, H. R., Wohlfahrt‐Veje, C., Dalgård, C., Christiansen, L., Main, K. M., Nellemann, C., Murata, K., Jensen, T. K., Skakkebæk, N. E., & Grandjean, P. (2012) · PLoS ONE · doi:10.1371/journal.pone.0036830 · Cited by 46
“There is increasing evidence that prenatal and early postnatal environmental factors might influence the risk [49,50].”
Oyston, C., Stanley, J. L., Oliver, M. H., Bloomfield, F. H., & Baker, P. N. (2016) · Hypertension · doi:10.1161/hypertensionaha.116.07662 · Cited by 46
“These fetuses have an increased risk of significant perinatal morbidity and mortality,(1,2) neurodevelopmental impairment in childhood,(3) and an increased risk of adult onset chronic diseases.(4) Currently, there are no clinically available treatments that can improve fetal growth.”
BackgroundKramer, M. S., Zhang, X., Dahhou, M., Yang, S., Martin, R. M., Oken, E., & Platt, R. W. (2017) · American Journal of Epidemiology · doi:10.1093/aje/kww109 · Cited by 50
Cope, H. A., Blake, B. E., Love, C. A., McCord, J. P., Elmore, S. A., Harvey, J. B., Chappell, V. A., & Fenton, S. E. (2021) · Emerging contaminants · doi:10.1016/j.emcon.2021.10.004 · Cited by 47
“Low weight at birth and in early life has been associated with the development of metabolic syndrome later in life in humans and mouse models [5,58,59].”
BackgroundPan, I., Daniels, J. L., Herring, A. H., Rogan, W. J., Siega‐Riz, A. M., Goldman, B. D., & Sjödin, A. (2010) · Paediatric and Perinatal Epidemiology · doi:10.1111/j.1365-3016.2010.01114.x · Cited by 45
Lim, A. L., Ng, S., Leow, S. C. P., Choo, R. W. M., Ito, M., Chan, Y. H., Goh, S. K., Tng, E., Kwek, K. Y. C., Chong, Y. S., et al. (2012) · Journal of Medical Genetics · doi:10.1136/jmedgenet-2012-100858 · Cited by 45
Prenatal origins of postnatal variation in growth, development and productivity of ruminants
Bell, A. W., & Greenwood, P. L. (2016) · Animal Production Science · doi:10.1071/an15408 · Cited by 45
Higher concentrations of branched-chain amino acids in breast milk of obese mothers
Luca, A. D., Hankard, R., Alexandre-Gouabau, M. C., Ferchaud‐Roucher, V., Darmaun, D., & Boquien, C. (2016) · Nutrition · doi:10.1016/j.nut.2016.05.013 · Cited by 45
Abrous, D. N., Koehl, M., & Lemoine, M. (2021) · Molecular Psychiatry · doi:10.1038/s41380-021-01172-4 · Cited by 51
Prenatal programming of postnatal productivity and health of livestock: a brief review
Bell, A. W. (2006) · Australian Journal of Experimental Agriculture · doi:10.1071/ea06006 · Cited by 45
“During the late 1980s and early 1990s, Barker and colleagues published a series of papers, briefly reviewed by Barker (2004), suggesting inverse relations between birth weight and the incidence or risk of death from several common matureonset diseases, including cardiovascular disease, stroke, impaired glucose toleran…”
BackgroundRole of nutrients in the development of neonatal immune response
Cunningham–Rundles, S., Lin, H., Lin, D. H., Dnistrian, A. M., Cassileth, B. R., & Perlman, J. M. (2009) · Nutrition Reviews · doi:10.1111/j.1753-4887.2009.00236.x · Cited by 45
Óvilo, C., Gonzalez‐Bulnes, A., Benítez, R., Ayuso, M., Barbero-Fernández, A., Pérez-Solana, M. L., Barragán, C., Astiz, S., Fernández, A., & López-Bote, C. J. (2013) · British Journal Of Nutrition · doi:10.1017/s0007114513002948 · Cited by 45
Balaguer, N., Moreno, I., Herrero, M., Gonzáléz-Monfort, M., Vilella, F., & Simón, C. (2019) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2019.02.047 · Cited by 45
Metadata
- Authors
- Barker, D.
- Affiliations
- Southampton General Hospital (GB)
- Corresponding author
- Barker, DJP
- Venue
- Acta Paediatrica
- Publisher
- Wiley
- Published
- 2004-11
- Volume
- 93
- Issue
- s446
- Pages
- 26-33
- ISSN
- 0365-1436 (ISSN-L)
- 0803-5253
- 1651-2227
- OpenAlex
- W2143230895
- Cited by
- 790
- References
- 53
- Citations by year
- 2026: 19 · 2025: 38 · 2024: 49 · 2023: 42 · 2022: 36 · 2021: 63 · 2020: 55 · 2019: 42 · 2018: 39 · 2017: 37 · 2016: 33 · 2015: 40 · 2014: 37 · 2013: 40 · 2012: 45
- FWCI
- 17.36
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Acta Paediatrica (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 › Pediatrics, Perinatology and Child Health › Prenatal Substance Exposure Effects
- Keywords
- developmental origins of health and disease, low birth weight, coronary artery disease, stroke, hypertension, type 2 diabetes, developmental plasticity, fetal growth restriction, gestational age, child weight gain, environmental influences on development
- MeSH terms
- Adult, Birth Weight, Cardiovascular Diseases, Child, Child Development, Child, Preschool, Chronic Disease, Diabetes Mellitus, Type 2, Female, Humans, Infant, Infant, Newborn, Male
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