Birthweights, maternal cardiovascular events, and Barker hypothesis

It is well established that the intrauterine environment has an important impact on the subsequent health of various animals. 1 Langley SC Jackson AA Increased systolic blood pressure in adult rats induced by fetal exposure to maternal low protein diets. Clin Sci (Colch). 1994; 86: 217-222 Google Scholar However, whether intrauterine programming determines certain aspects of adult health in human beings remains controversial. 2 Paneth N Susser M Early origin of coronary heart disease (the “Barker hypothesis”). BMJ. 1995; 310: 411-412 Crossref PubMed Scopus (250) Google Scholar , 3 Susser M Levin B Ordeals for the fetal programming hypothesis. BMJ. 1999; 318: 885-886 Crossref PubMed Scopus (41) Google Scholar Several anthropometric variables present at birth or in early infancy have been associated with the development in adulthood of risk factors for cardiovascular disease—ie, hypertension or diabetes—or of coronary heart disease itself. 4 Barker DJP Mothers, babies and disease in later life. BMJ Publishing, London1994 Google Scholar The many reports on this topic have polarised clinicians and scientists into camps of believers and non-believers. This segregation has even extended into the publication of the reports in The Lancet or the BMJ. 5 Ben-Schlomo Y Davey Smith G “Place of publication” bias?. BMJ. 1994; 309: 274 Crossref PubMed Scopus (8) Google Scholar Birthweight, early environment, and genetics: a study of twins discordant for acute myocardial infarctionThe lack of an association between birth characteristics and AMI within twin pairs suggests that previously reported associations may be influenced by genetic and early environmental factors, or possibly, by unmeasured maternal factors that operate independently of birthweight. Full-Text PDF Pregnancy complications and maternal risk of ischaemic heart disease: a retrospective cohort study of 129 290 birthsComplications of pregnancy linked to low birthweight are associated with an increased risk of subsequent IHD in the mother. Common genetic risk factors might explain the link between birthweight and risk of IHD in both the individual and the mother. Full-Text PDF