Cardiometabolic and Renal DOHaD Outcomes in Offspring of Complicated Pregnancy

It is now over thirty years since epidemiological studies revealed a relationship between low birth weight and subsequent risk of developing traditionally adult-onset diseases, such as type 2 diabetes, cardiovascular and renal disease. Initial focus was directed towards the importance of fetal undernutrition. However, it is now recognized that a range of other in utero adverse exposures including chronic fetal hypoxia, maternal over-nutrition and maternal stress can also lead to increased risk of cardio-metabolic and renal diseases in later life. Animal models, including those using non-human primates, sheep and rodents have been critical in demonstrating causality of relationships and helped to define underlying mechanisms, such as epigenetic programming of gene expression and oxidative stress. As the field moves forward in the coming years, these mechanistic studies will help to identify rational intervention strategies to reduce the developmental programming of cardiometabolic and renal dysfunction in suboptimal pregnancy.