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Lancet. 2018 May 5;391(10132):1842-1852. doi: 10.1016/S0140-6736(18)30312-X. Epub 2018 Apr 16.

Origins of lifetime health around the time of conception: causes and consequences.

Author information

1
Biological Sciences, University of Southampton, Southampton, UK.
2
School of Medicine, Division of Child Health, Obstetrics and Gynaecology, University of Nottingham, Nottingham, UK.
3
School of Natural and Environmental Sciences, Newcastle University, Newcastle, UK.
4
Human Nutrition Research Centre, Institute of Cellular Medicine and Newcastle University Institute for Ageing, Newcastle University, Newcastle, UK.
5
MRC Unit, The Gambia and MRC International Nutrition Group, London School of Hygiene & Tropical Medicine, London, UK.
6
UCL EGA Institute for Women's Health, Faculty of Population Health Sciences, University College London, London, UK.
7
MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK; NIHR Southampton Biomedical Research Centre, University of Southampton & University Hospital Southampton NHS Foundation Trust, Southampton, UK.
8
Cancer & Disease Epigenetics, Murdoch Children's Research Institute and Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia.
9
KEM Hospital Research Centre, Pune, India.
10
Institute of Developmental Sciences, University of Southampton, Southampton, UK.
11
Institute of Developmental Sciences, University of Southampton, Southampton, UK; NIHR Southampton Biomedical Research Centre, University of Southampton & University Hospital Southampton NHS Foundation Trust, Southampton, UK.
12
University of the West Indies Solutions for Developing Countries, The University of the West Indies, Mona, Jamaica.
13
Liggins Institute, University of Auckland, Auckland, New Zealand; Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore, Singapore.
14
MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK; Institute of Developmental Sciences, University of Southampton, Southampton, UK; NIHR Southampton Biomedical Research Centre, University of Southampton & University Hospital Southampton NHS Foundation Trust, Southampton, UK. Electronic address: kmg@mrc.soton.ac.uk.

Abstract

Parental environmental factors, including diet, body composition, metabolism, and stress, affect the health and chronic disease risk of people throughout their lives, as captured in the Developmental Origins of Health and Disease concept. Research across the epidemiological, clinical, and basic science fields has identified the period around conception as being crucial for the processes mediating parental influences on the health of the next generation. During this time, from the maturation of gametes through to early embryonic development, parental lifestyle can adversely influence long-term risks of offspring cardiovascular, metabolic, immune, and neurological morbidities, often termed developmental programming. We review periconceptional induction of disease risk from four broad exposures: maternal overnutrition and obesity; maternal undernutrition; related paternal factors; and the use of assisted reproductive treatment. Studies in both humans and animal models have demonstrated the underlying biological mechanisms, including epigenetic, cellular, physiological, and metabolic processes. We also present a meta-analysis of mouse paternal and maternal protein undernutrition that suggests distinct parental periconceptional contributions to postnatal outcomes. We propose that the evidence for periconceptional effects on lifetime health is now so compelling that it calls for new guidance on parental preparation for pregnancy, beginning before conception, to protect the health of offspring.

PMID:
29673874
PMCID:
PMC5975952
[Available on 2018-11-05]
DOI:
10.1016/S0140-6736(18)30312-X

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