Perinatal programming and blood pressure

Adverse intrauterine and perinatal events may have profound effects on the fetus and neonate. This chapter discusses both epidemiologic data and experimental models that elucidate those factors involved in perinatal programming and developmental origins of adult disease. Persons who have been born after exposure to an adverse intrauterine environment may be at higher risk of future diseases than those born after uneventful gestation. This phenomenon has been called "perinatal programming," a term suggesting the importance of the milieu during organogenesis to future events. The mechanisms by which perinatal programming occurs are multiple, involving subtle changes in development, changes in expression of various proteins, and, likely, epigenetic changes. Infants who are small for gestational age or are premature appear to be at high risk to be subject to the effects of programming. Whether such people should be considered as having an "extra" risk factor for hypertension and cardiovascular disease, as well as for metabolic syndrome and other conditions, is discussed in this chapter.