Perinatal programming and risk of chronic diseases: Metabolic, cardiovascular, renal, and neuroimmune impacts in adulthood
DOI:
https://doi.org/10.33448/rsd-v15i1.50516Keywords:
Perinatal care, Chronic disease, Kidney diseases.Abstract
The perinatal period spans from conception to the seventh day after delivery, being a period of fetal formation whose influences can have repercussions in postnatal life. A biologically critical phase, in which adaptive mechanisms mediated by epigenetic, metabolic, hormonal, and inflammatory processes durably shape the functionality of organic systems. Perturbations during this interval, including prematurity, intrauterine growth restriction (IUGR), maternal metabolic dysfunctions, alterations in the microbiota, and environmental exposures can impact renal, cardiovascular, pulmonary, neuroendocrine, and immunometabolic maturation, posing a risk for the development of chronic diseases throughout life, such as Diabetes Mellitus (DM), Systemic Arterial Hypertension (SAH), and Chronic Kidney Disease (CKD) may occur. This study aimed to describe the most impactful influences during pregnancy and early postnatal life and their consequences in adult life. An integrative review was conducted, with articles from 2020 to 2025, in the PubMed database, in the English language, with the keywords: Perinatal Care, Chronic Disease, and Chronic Kidney Disease. Emphasis is placed on the biological mechanisms underlying adverse fetal programming, with a focus on the interfaces between metabolism, hemodynamics, inflammation, and cellular signaling. The results reinforce that the perinatal environment acts as a fundamental determinant of adult health, highlighting the need for preventive strategies aimed at metabolic and environmental protection of the pregnant woman and newborn. Prematurity, IUGR, low birth weight, maternal obesity, and maternal DM are the main agents that impact the perinatal environment and increase the risk for chronic diseases, mainly DM, SAH, CKD, and obesity.
References
Alvarez-Elias, A. C., Brenner, B. M., & Luyckx, V. A. (2024). Climate change and its influence in nephron mass. Current Opinion in Nephrology and Hypertension, 33(1), 102–109.
Bellalta, S., Plösch, T., Faas, M., & Casanello, P. (2024). The role of mesenchymal stem cells in early programming of adipose tissue in the offspring of women with obesity. Pediatric Obesity, 19(6), e13120. https://onlinelibrary.wiley.com/doi/10.1111/ijpo.13120
Catassi, G., Mateo, S. G., Occhionero, A. S., Esposito, C., Giorgio, V., Aloi, M., Gasbarrini, A., Cammarota, G., & Ianiro, G. (2024). The importance of gut microbiome in the perinatal period. European Journal of Pediatrics, 183(12), 5085–5101. https://doi.org/10.1007/s00431-024-05795-x
Chevalier, R. L. (2020). Bioenergetic evolution explains prevalence of low nephron number at birth: risk factor for CKD. Kidney360, 1(8), 863–879. https://journals.lww.com/kidney360/fulltext/2020/08000/bioenergetic_evolution_explains_prevalence_of_low.20.aspx
Collaco, J. M., Aoyama, B. C., Rice, J. L., & McGrath-Morrow, S. A. (2021). Influences of environmental exposures on preterm lung disease. Expert Review of Respiratory Medicine, 15(10), 1271–1279. https://doi.org/10.1080/17476348.2021.1941886
Crossetti, M. G. O. (2012). Revisão integrativa de pesquisa na enfermagem: o rigor metodológico que lhe é exigido. Revista Gaúcha de Enfermagem, 33(2), 10-11.
Crump, C. (2020). An overview of adult health outcomes after preterm birth. Early Human Development, 150, 105187. https://doi.org/10.1016/j.earlhumdev.2020.105187
Denizli, M., Capitano, M. L., & Kua, K. L. (2022). Maternal obesity and the impact of associated early-life inflammation on long-term health of offspring. Frontiers in Cellular and Infection Microbiology, 12, 940937. https://doi.org/10.3389/fcimb.2022.940937
Duke, J. W., & Lovering, A. T. (2020). Respiratory and cardiopulmonary limitations to aerobic exercise capacity in adults born preterm. Journal of Applied Physiology, 129(4), 718–724. https://doi.org/10.1152/japplphysiol.00419.2020
Duke, J. W., Lewandowski, A. J., Abman, S. H., & Lovering, A. T. (2022). Physiological aspects of cardiopulmonary dysanapsis on exercise in adults born preterm. The Journal of Physiology, 600(3), 463–482. https://doi.org/10.1113/JP281848
Fanni, D., Gerosa, C., Nurchi, V. M., Manchia, M., Saba, L., Coghe, F., Crisponi, G., Gibo, Y., Van Eyken, P., Fanos, V., & Faa, G. (2021). The Role of Magnesium in Pregnancy and in Fetal Programming of Adult Diseases. Biological Trace Element Research, 199(10), 3647–3657. https://doi.org/10.1007/s12011-020-02513-0
Fukunaga, S., & Fujita, Y. (2023). Low glomerular number at birth can lead to the development of chronic kidney disease. Frontiers in Endocrinology, 14, 1120801. https://doi.org/10.3389/fendo.2023.1120801
Kanbay, M., Copur, S., Yildiz, A. B., Covic, A., Covic, A., Ciceri, P., Magagnoli, L., & Cozzolino, M. (2023). Intrauterine life to adulthood: a potential risk factor for chronic kidney disease. Nephrology Dialysis Transplantation, 38(12), 2675–2684. https://doi.org/10.1093/ndt/gfad134
Liu, L., Wen, Y., Ni, Q., Chen, L., & Wang, H. (2023). Prenatal ethanol exposure and changes in fetal neuroendocrine metabolic programming. Biological Research, 56(1), 61. https://doi.org/10.1186/s40659-023-00473-y
Mattos, M. C. (2015). Revisão integrativa da literatura: orientações para sua elaboração. Revista da Escola de Enfermagem da USP, 49(5), 875-882.
Nohesara, S., Abdolmaleky, H. M., Dickerson, F., Pinto-Tomás, A. A., Jeste, D. V., & Thiagalingam, S. (2024). Maternal gut microbiome-mediated epigenetic modifications in cognitive development and impairments: a new frontier for therapeutic innovation. Nutrients, 16(24), 4355. https://doi.org/10.3390/nu16244355
Oulerich, Z., & Sferruzzi-Perri, A. N. (2024). Early-life exposures and long-term health: adverse gestational environments and the programming of offspring renal and vascular disease. American Journal of Physiology – Renal Physiology, 327(1), F21–F36. https://doi.org/10.1152/ajprenal.00383.2023
Page M. J., McKenzie J. E., Bossuyt P. M., Boutron I., Hoffmann T. C., Mulrow C. D., Shamseer L., Tetzlaff J. M., Akl E. A., Brennan S. E., Chou R., Glanville J., Grimshaw J. M., Hróbjartsson A., Lalu M. M., Li T., Loder E. W., Mayo-Wilson E., McDonald S., McGuinness L. A., Stewart L. A., Thomas J., Tricco A. C., Welch V. A., Whiting P., & Moher D. (2022). A declaração PRISMA 2020: diretriz atualizada para relatar revisões sistemáticas. Rev Panam Salud Publica. 30;46:e112. https://doi.org/10.26633/RPSP.2022.112.
Priviero, F. (2023). Epigenetic modifications and fetal programming: molecular mechanisms to control hypertension inheritance. Biochemical Pharmacology, 208, 115412. https://doi.org/10.1016/j.bcp.2023.115412.
Shawky, N. M. (2022). Cardiovascular disease risk in offspring of polycystic ovary syndrome. Frontiers in Endocrinology, 13, 977819. https://doi.org/10.3389/fendo.2022.977819
Soares, C. B., Hoga, L. A. K., Peduzzi, M., Sangaleti, C., Yonekura, T., & Silva, D. R. A. D. (2014). Revisão integrativa: conceitos e métodos utilizados na enfermagem. Revista da Escola de Enfermagem da USP, 48(2), 335-345. https://doi.org/10.1590/S0080-6234201400002000020
Tain, Y. L., & Hsu, C. N. (2024). Amino acids during pregnancy and offspring cardiovascular-kidney-metabolic health. Nutrients, 16(9), 1263. https://doi.org/10.3390/nu16091263
Yuan, C., Dong, Y., Chen, H., Ma, L., Jia, L., Luo, J., Liu, Q., Hu, Y., Ma, J., & Song, Y. (2024). Determinants of childhood obesity in China. The Lancet Public Health, 9(12), e1105–e1114. https://doi.org/10.1016/
Zhang, L., Agrawal, M., Ng, S. C., & Jess, T. (2024). Early-life exposures and the microbiome: implications for IBD prevention. Gut, 73(3), 541–549. https://gut.bmj.com/content/73/3/541
Downloads
Published
Issue
Section
License
Copyright (c) 2026 Isabela Rocha Ribeiro, João Pedro Silva Alves, Gilson Fernandes Ruivo
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
1) Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
2) Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
3) Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.
