Zhang Lubo
Center for Perinatal Biology, Department of Physiology and Pharmacology, Loma Linda University School of Medicine, Loma Linda, California 92350, USA.
J Soc Gynecol Investig. 2005 Jan;12(1):2-13. doi: 10.1016/j.jsgi.2004.09.004.
Epidemiologic studies have shown a clear association of adverse intrauterine environment and an increased risk of hypertension and coronary heart disease in the adult. Many studies have been focused on the effects of maternal undernutrition and fetal glucocorticoid exposure on fetal programming and later adult disease. Although it is relatively less clear, there is evidence that fetal exposure to hypoxia, alcohol, tobacco smoking, and cocaine may also cause in utero programming leading to an increased risk of adult disease. Chronic hypoxia during the course of pregnancy is thought to result in fetal intrauterine growth retardation. Among other effects, chronic hypoxia suppresses fetal cardiac function, alters cardiac gene expression, increases myocyte apoptosis, and results in a premature exit of the cell cycle of cardiomyocytes and myocyte hypertrophy. This review discusses recent evidence of an association of prenatal hypoxic exposure with an increased vulnerability of adult heart disease, and the possible mechanisms involved.
流行病学研究表明，不良的子宫内环境与成年人患高血压和冠心病风险增加之间存在明确关联。许多研究聚焦于母亲营养不足和胎儿糖皮质激素暴露对胎儿编程及成年后疾病的影响。尽管相对不那么明确，但有证据表明，胎儿暴露于缺氧、酒精、吸烟和可卡因环境也可能导致子宫内编程，从而增加成年疾病风险。孕期慢性缺氧被认为会导致胎儿宫内生长受限。除其他影响外，慢性缺氧会抑制胎儿心脏功能、改变心脏基因表达、增加心肌细胞凋亡，并导致心肌细胞细胞周期过早退出和心肌细胞肥大。本综述讨论了产前缺氧暴露与成年心脏病易感性增加之间关联的最新证据以及其中可能涉及的机制。
