Environmental factors in utero may trigger adult chronic illness

The long latency period between exposure to an environmental trigger and cancer has already been recognized, but the same phenomenon may apply to chronic diseases such as metabolic disease and osteoporosis, with exposure to triggers in utero and early life causing disease in adulthood, according to a report published in the July 3 issue of the New England Journal of Medicine.

Peter D. Gluckman, MD, of the University of Auckland in New Zealand, and colleagues summarized the evidence to date from a range of disciplines that supports the thesis that, so far, the role of environmental factors during development has been underestimated in susceptibility to chronic disease in adulthood.

The implications of the relation between fetal/infant growth and development and health in adulthood are that it reinforces the need for health education prior to parenthood, and also the need to approach health care with a life-course perspective, the report suggests.

“The outcome of a pregnancy must be considered in terms of maternal and neonatal health, the growth and cognitive development of the infant, its health as an adult, and even the health of subsequent generations,” the authors write. “It is essential to learn how influences on early development will interact with the physiologic processes of developmental plasticity to determine patterns of noncommunicable chronic disease.”

Gluckman PD, Hanson MA, Cooper C, et al. Effect of in utero and early life conditions on adult health and disease. N Engl J Med. 2008;359:61-73.