1 MRC Human Genetics Unit, Institute of Genetics and Molecular Medicine, University of Edinburgh , Edinburgh EH4 2XU , UK.
2 British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, The Queen's Medical Research Institute , Edinburgh EH16 4TJ , UK.
Philos Trans R Soc Lond B Biol Sci. 2019 Apr 15;374(1770):20180121. doi: 10.1098/rstb.2018.0121.
Preterm birth is a significant public health problem worldwide, leading to substantial mortality in the newborn period, and a considerable burden of complications longer term, for affected infants and their carers. The fact that it is so common, and rates vary between different populations, raising the question of whether in some circumstances it might be an adaptive trait. In this review, we outline some of the evolutionary explanations put forward for preterm birth. We specifically address the hypothesis of the predictive adaptive response, setting it in the context of the Developmental Origins of Health and Disease, and explore the predictions that this hypothesis makes for the potential causes and consequences of preterm birth. We describe how preterm birth can be triggered by a range of adverse environmental factors, including nutrition, stress and relative socioeconomic status. Examining the literature for any associated longer-term phenotypic changes, we find no strong evidence for a marked temporal shift in the reproductive life-history trajectory, but more persuasive evidence for a re-programming of the cardiovascular and endocrine system, and a range of effects on neurodevelopment. Distinguishing between preterm birth as a predictive, rather than immediate adaptive response will depend on the demonstration of a positive effect of these alterations in developmental trajectories on reproductive fitness. This article is part of the theme issue 'Developing differences: early-life effects and evolutionary medicine'.
早产是一个全球性的重大公共卫生问题，导致新生儿期大量死亡，并给受影响的婴儿及其照顾者带来长期并发症的巨大负担。事实上，早产非常普遍，而且不同人群的发生率存在差异，这就提出了一个问题，即在某些情况下，它是否可能是一种适应性特征。在这篇综述中，我们概述了为早产提出的一些进化解释。我们特别探讨了预测适应性反应的假说，将其置于健康与疾病的发育起源的背景下，并探讨了这一假说对早产潜在原因和后果的预测。我们描述了早产如何被一系列不良环境因素触发，包括营养、压力和相对社会经济地位。我们在文献中检查了任何相关的长期表型变化，并没有发现生殖生命史轨迹明显的时间转移的有力证据，但有更有说服力的证据表明心血管和内分泌系统的重新编程，以及对神经发育的一系列影响。区分作为预测性而非即时适应性反应的早产将取决于对这些发育轨迹变化对生殖适应性的积极影响的证明。本文是“发展差异：早期生活效应和进化医学”主题专刊的一部分。
