Fetal and Neonatal Programming in Current Practice

Fetal and neonatal programming is a phenomenon produced by deviations from the normal development during prenatal or early postnatal life. These deviations can increase risk for different diseases later in life and are an example of phenotypic plasticity throughout the nature. For instance, infants born with low birth weight, as a marker of an unfavorable intrauterine environment, are programmed differently and face additional challenges in adulthood; thereby encountering more risks for coronary artery diseases, diabetes, hypertension, metabolic syndrome, imbalanced immune response, renal insufficiency, and suboptimal cognition. Advances in research in the last decade significantly improved the understanding of underlying mechanisms. Once these mechanisms are understood it is very tempting to implicate them into management. However, the risk and benefit of each new implication into clinical practice need to be considered carefully and evaluated by randomized controlled trials. This chapter will propose and discuss some of the possible clinical implications of fetal and neonatal programming which can lead to possible changes in current clinical management in reflection of latest knowledge on this topic.

Keywords: Neonatal programming, gestational age pregnancy, postnatal nutrition, neuro-developmental impairment, malnutrition