Murphy Michelle M, Santos-Calderón Luis Adolfo
Unit of Preventive Medicine & Biostatistics, Faculty of Medicine & Health Sciences, Universitat Rovira i Virgili (URV), Reus, Spain.
Institut d'Investigació Sanitària Pere Virgili, Tarragona, Spain.
Pediatr Res. 2024 Nov 14. doi: 10.1038/s41390-024-03726-y.
The developmental origins of health and disease hypothesis propose that lifelong health is programmed during foetal development, in utero. The world's population is ageing due to increased longevity but expanding morbidity and the associated burden on health systems around the planet, are associated with this. Consequently, resources are strained and spent largely on treating patients rather than preventing chronic diseases at their source. Research on early life exposures, starting in the womb, is needed to identify new potential biomarkers linked with the development of chronic diseases during adulthood. Evidence from maternal-offspring cohorts investigating associations between pregnancy exposures and childhood metabolic health is reviewed (The GUSTO study in Singapore, the Copenhagen Prospective Studies on Asthma in Childhood, a mother-child cohort in rural Gambia, the MINIMat study in Bangladesh, The Iodine Status in Pregnancy and Offspring Health Cohort in China, the OBESO cohort in Mexico, the Pune Nutrition study in India, The Reus-Tarragona Birth Cohort study in Spain). Collectively, evidence from prospective observational studies, randomised controlled trials and animal studies, supports the hypothesis that maternal diet, lifestyle and nutritional status during pregnancy are associated with childhood metabolic health in the offspring. However, the evidence is scant and further research is needed.
健康与疾病的发育起源假说提出，终生健康在子宫内胎儿发育期间就已被编程。由于寿命延长，世界人口正在老龄化，但全球发病率不断上升以及对卫生系统造成的相关负担也与此相关。因此，资源紧张，且大部分用于治疗患者而非从源头上预防慢性病。需要开展从子宫内开始的早期生命暴露研究，以确定与成年期慢性病发展相关的新潜在生物标志物。本文综述了母婴队列研究中关于孕期暴露与儿童代谢健康之间关联的证据（新加坡的GUSTO研究、哥本哈根儿童哮喘前瞻性研究、冈比亚农村的母婴队列、孟加拉国的MINIMat研究、中国的孕期碘营养状况与子代健康队列、墨西哥的OBESO队列、印度的浦那营养研究、西班牙的雷乌斯-塔拉戈纳出生队列研究）。总体而言，前瞻性观察性研究、随机对照试验和动物研究的证据支持以下假说：孕期母亲的饮食、生活方式和营养状况与子代儿童期代谢健康相关。然而，证据不足，需要进一步研究。
