Regulation of placental nutrient transport--a review.

Substrate supply to the fetus is a major regulator of prenatal growth. Maternal nutrition influences the availability of nutrients for transfer to the fetus. Animal experiments demonstrate that restriction of maternal protein or energy intake can retard fetal growth. Effects of maternal nutrition vary with the type and timing of the restriction and the species studied. Maternal undernutrition before conception and/or in early pregnancy can alter fetal physiology in late gestation, and influence postnatal function, often without measurable effects on birth size. In contrast, to date, observational and intervention studies in humans provide limited support for a major role of maternal nutrition in determining birth size, except where women are quite malnourished. However, recent studies report associations between newborn size and the balance of macronutrients in women's diets in Western settings. Associations between maternal dietary composition and adult blood pressure of the offspring are also reported in human populations. Most studies in women have focused on dietary content or supplementation during mid-late pregnancy. Further investigation of how maternal dietary composition, before conception and throughout pregnancy, affects fetal physiology and health of the baby will increase the understanding of how maternal diet and nutritional status influence fetal, neonatal and longer-term outcomes.

Diet around conception and during pregnancy – effects on fetal and neonatal outcomes

Many aspects of postnatal development are influenced by events before birth, including cognitive and language development. An adverse intrauterine environment, for example secondary to poor maternal nutritional status, multiple pregnancy, or late preterm birth, is associated with increased risks of delayed or impaired childhood development and altered physiology in adulthood that may predispose to increased risk of adult disease. Maternal periconceptional undernutrition and twin conception can both result in late preterm birth, but it is less clear whether cases of late preterm birth not following a recognized early pregnancy event may still have their origin in the periconceptional period. Thus, the very earliest periods of pregnancy, and perhaps even the pre-pregnancy period, may be an important period determining the developmental trajectory of the fetus, and thus both pregnancy and later health outcomes. Profound epigenetic modifications to the genome occur in the early embryo as a normal part of development. Recent evidence suggests that environmental signals acting during early development may also result in epigenetic changes which may play a role in mediating the association between early life exposures and later phenotype.

/pdf/epigenetic-modifications-may-play-a-role-in-the-jwwa6txo0j.pdf

Epigenetic modifications may play a role in the developmental consequences of early life events

Developmental effects on fetal circulation

The incidence of preterm birth in developed countries is increasing, and in some countries, including the United States, it is almost as high as in developing countries. Demographic changes in women becoming pregnant can account for only a relatively small proportion of the increase. A significant proportion of spontaneous preterm birth continues to be of unknown cause. Experimental data from animal studies suggesting that maternal undernutrition may play a role in spontaneous, noninfectious, preterm birth are supported by observational data in human populations, which support a role for maternal prepregnancy nutritional status in determining gestation length. In addition, intakes or lack of specific nutrients during pregnancy may influence gestation length and thus the risk of preterm birth. As yet, the role of paternal nutrition in contributing to gestation length is unexplored.

How Is Maternal Nutrition Related to Preterm Birth

Relationships between maternal body composition prior to conception and duration of gestation

Placental materno-fetal transfer of serine by amino acid exchangers

The influence of maternal diet on postnatal growth, development and physiology

Background: There is evidence in humans and experimental
animals for non-genomic transmission of induced phenotypes
between generations. Induction of an altered phenotype in
the F1 generation by feeding a protein-restricted (PR) diet to
pregnant rats involves altered epigenetic regulation of
specific genes. We investigated whether altered epigenetic
regulation of hepatic PPARa and glucocorticoid receptor (GR)
promoters induced in the F1 generation by prenatal undernutrition
is passed to the F2 offspring. Methods: Rats (F0) were fed a control (18% protein) or PR
(9% protein) diet throughout pregnancy and chow during
lactation. F1 females were mated and fed chow throughout
pregnancy and lactation. F1 and F2 offspring were fed chow.
Male offspring from the F1 and F2 generations (n =6 per F0
dietary group) were killed at day 80. Methylation of the
hepatic PPARa and GR promoters was determined by
methylation-sensitive real-time PCR. mRNA expression was
measured by real-time RT-PCR. Results: Methylation of the hepatic PPARa and GR promoters
was lower (8% to 11%, p b0.05) in the F1 and F2 PR offspring.
There were trends towards higher PPARa and GR expression
in the PR offspring.

Feeding a protein-restricted diet during pregnancy in the rat induces altered gene promoter methylation in the liver of the F1 and F2 offspring [In special abstracts issue]

Moderate early gestation undernutrition has no effect on kidney size and function in late gestation

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