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Teoría de Barker sobre programación fetal

El epidemiólogo inglés David Barker y sus colegas de la Universidad de Southampton descubrieron mucho de lo que se conoce acerca del impacto de por vida del crecimiento y desarrollo temprano. Su trabajo innovador ha inaugurado un nuevo campo en la medicina y una forma totalmente nueva de promocionar la salud y prevenir enfermedades.

"Programación fetal" es la frase utilizada a menudo para describir los cambios permanentes originados por el entorno prenatal.21


Asociaciones entre factores prenatales y salud de por vida


Antes del embarazo o durante él...

Cuando una madre carece de: … su bebé es más propenso a desarrollar:
ácido fólico espina bífida,22 nacimiento prematuro23
yodo daño cerebral,24 hipotiroidismo25
vitamina D osteoporosis26
vitamina E asma27

Durante el embarazo...

Cuando una madre: … su bebé es más propenso a desarrollar:
sufre estrés y ansiedad excesivos trastorno por déficit de atención con hiperactividad y ansiedad28
fuma cigarrillos trastorno por déficit de atención con hiperactividad,29 trastorno del comportamiento,30 obesidad,31 diabetes,32 enfermedades cardíacas,33 nacimiento prematuro,34 parto de niño muerto,35 síndrome de muerte súbita infantil*36
toma alcohol síndrome alcohólico fetal,37 alcoholismo,38 trastorno del comportamiento,39 trastorno por déficit de atención con hiperactividad,40 nacimiento prematuro41

*síndrome de muerte súbita infantil


Esperanza para el futuro

Es importante recordar que, aunque estos factores prenatales aumentan el riesgo de ciertas complicaciones, no garantizan de ninguna manera que surgirá una complicación.

Aquellas mujeres que hayan tenido un embarazo un tanto complicado no deberían entrar en pánico ni perder las esperanzas. Incluso si surgen problemas, la mayoría son tratables y muchos presentan otros factores de riesgo que pueden modificarse para minimizar el riesgo. La buena noticia es que ya se han descubierto formas de prevenir o minimizar las consecuencias a largo plazo.42

No obstante, dadas las muchas asociaciones entre los eventos prenatales y la salud de por vida que se han informado en el todo el mundo, es imperativo que hagamos todo lo que esté a nuestro alcance para mejorar la nutrición y la salud de las mujeres, mucho tiempo antes de la concepción, y durante el embarazo y la lactancia.


Notas al pie
21 Barker DJP, 1998a. 13.
22 Williams JL et al., 2006. S67; Williams LJ et al., 2005. 580.
23 Bukowski R et al., 2009. 6.
24 The world health report 2002 - Reducing Risks, Promoting Healthy Life, 2002. 4.
25 Haddow JE et al., 1999. 549.
26 Cooper C et al., 2005. 2730S-2731S; Javaid MK et al., 2006. 36.
27 Devereux G et al., 2006. 502; Litonjua AA et al., 2006. 853.
28 Van den Bergh BR, Marcoen A, 2004. 1092.
29 Linnet KM et al., 2003. 1028; Braun JM et al., 2006. 1904; Millichap JG, 2008. e360.
30 Wakschlag LS et al., 1997. 670; Fergusson DM et al., 1998. 726; Langley K et al., 2007. e-article.
31 Adams AK et al,, 2005. 396-397; Dubois and Girard, 2006. 610, 617; Power C, Jefferis BJ, 2002. 416-417; Montgomery SM, Ekbom A, 2002. 26-27; Bergen HT, 2006. 6; von Kries R et al., 2002. 954, 956.
32 Ong KK, Dunger DB, 2002. 202; International Diabetes Federation website, 2002. e-article.
33 Barker, Winter, et al., 1989. 579; Barker DJ, 1999. 305.
34 Spong CY, 2007. 407; Cnattingius S et al., 1999. 947; Brooks DR et al., 2004. 999.
35 Salihu HM, Wilson RE, 2007. 713, 717.
36 Salihu HM, Wilson RE, 2007. 717-718; Chong DS et al., 2004. 471, 478.
37 FASD: What Everyone Should Know. 1.
38 Griesler PC, Kandel DB, 1998. 297; Baer JS et al., 2003. 377, 383.
39 Fryer SL et al., 2007. e737.
40 Fryer SL et al., 2007. e737.
41 Sokol RJ et al., 2007. 1031, 1035.
42 Eriksson JG et al., 2004. 164, 166; Fasting MH et al., 2008. 2, 5; Goldschmidt L et al., 1996. 769.

Bibliografía

Adams AK, Harvey HE, Prince RJ. 2005. Association of maternal smoking with overweight at age 3 y in American Indian children. Am J Clin Nutr. 82:393-398.
Buscar en EHD Ref. / Resumen Texto completo

Baer JS, Sampson PD, Barr HM, Connor PD, Streissguth AP. 2003. A 21-year longitudinal analysis of the effects of prenatal alcohol exposure on young adult drinking. Arch Gen Psychiatry. Apr;60(4):377-85.
Buscar en EHD Ref. / Resumen Texto completo

Barker DJ, Winter PD, Osmond C, Margetts B, Simmonds SJ. 1989. Weight in infancy and death from ischaemic heart disease. Lancet. 2:577-580.
Buscar en EHD Ref. / Resumen

Barker DJ. 1999. Early growth and cardiovascular disease. Arch Dis Child. Apr;80(4):305-7.
Buscar en EHD Ref. / Resumen Texto completo

Barker DJP. 1998. Mothers, babies and health in later life, Second edition. Churchill Livingstone.
Buscar en EHD

Bergen HT. 2006. Exposure to Smoke During Development: Fetal Programming of Adult Disease. Tobacco Induced Diseases. Vol. 3, No. 2:5-16.
Buscar en EHD

Braun JM, Kahn RS, Froehlich T, Auinger P, Lanphear BP. 2006. Exposures to environmental toxicants and attention deficit hyperactivity disorder in U.S. children. Environ Health Perspect. Dec;114(12):1904-9.
Buscar en EHD Ref. / Resumen Texto completo

Brooks DR, Mucci LA, Hatch EE, Cnattingius S. 2004. Maternal smoking during pregnancy and risk of brain tumors in the offspring. A prospective study of 1.4 million Swedish births. Cancer Causes Control. Dec;15(10):997-1005.
Buscar en EHD Ref. / Resumen Texto completo

Bukowski R, Malone FD, Porter FT, Nyberg DA, Comstock CH, Hankins GD, Eddleman K, Gross SJ, Dugoff L, Craigo SD, Timor-Tritsch IE, Carr SR, Wolfe HM, D'Alton ME. 2009. Preconceptional folate supplementation and the risk of spontaneous preterm birth: a cohort study. PLoS Med. May 5;6(5):e1000061.
Buscar en EHD Ref. / Resumen

Chong DS, Yip PS, Karlberg J. 2004. Maternal smoking: an increasing unique risk factor for sudden infant death syndrome in Sweden. Acta Paediatr. Apr;93(4):471-8.
Buscar en EHD Ref. / Resumen Texto completo

Cnattingius S, Granath F, Petersson G, Harlow BL. 1999. The influence of gestational age and smoking habits on the risk of subsequent preterm deliveries. N Engl J Med. Sep 23;341(13):943-8.
Buscar en EHD Ref. / Resumen Texto completo

Cooper C, Javaid K, Westlake S, Harvey N, Dennison E. 2005. Developmental origins of osteoporotic fracture: the role of maternal vitamin D insufficiency. J Nutr. Nov;135(11):2728S-34S.
Buscar en EHD Ref. / Resumen Texto completo

Devereux G, Turner SW, Craig LC, McNeill G, Martindale S, Harbour PJ, Helms PJ, Seaton A. 2006. Low maternal vitamin E intake during pregnancy is associated with asthma in 5-year-old children. Am J Respir Crit Care Med. Sep 1;174(5):499-507.
Buscar en EHD Ref. / Resumen Texto completo

Dubois L, Girard M. 2006. Early determinants of overweight at 4.5 years in a population-based longitudinal study. Int J Obes (Lond). 30:610-617.
Buscar en EHD Ref. / Resumen Texto completo

Eriksson JG, Yliharsila H, Forsen T, Osmond C, Barker DJ. 2004. Exercise protects against glucose intolerance in individuals with a small body size at birth. Prev Med. Jul;39(1):164-7.
Buscar en EHD Ref. / Resumen Texto completo

FASD: What Everyone Should Know. FASD: What Everyone Should Know. National Organization on Fetal Alcohol Syndrome Website. National Organization on Fetal Alcohol Syndrome.
Buscar en EHD Texto completo

Fasting MH, Oien T, Storrø O, Nilsen TI, Johnsen R, Vik T. 2008. Maternal smoking cessation in early pregnancy and offspring weight status at four years of age. A prospective birth cohort study. Early Hum Dev. Jul 2.
Buscar en EHD Ref. / Resumen Texto completo

Fergusson DM, Woodward LJ, Horwood LJ. 1998. Maternal smoking during pregnancy and psychiatric adjustment in late adolescence. Arch Gen Psychiatry. Aug;55(8):721-7.
Buscar en EHD Ref. / Resumen Texto completo

Fryer SL, McGee CL, Matt GE, Riley EP, Mattson SN. 2007. Evaluation of psychopathological conditions in children with heavy prenatal alcohol exposure. Pediatrics. Mar;119(3):e733-41.
Buscar en EHD Ref. / Resumen Texto completo

Goldschmidt L, Richardson GA, Stoffer DS, Geva D, Day NL. 1996. Prenatal alcohol exposure and academic achievement at age six: a nonlinear fit. Alcohol Clin Exp Res. Jun;20(4):763-70.
Buscar en EHD Ref. / Resumen Texto completo

Griesler PC, Kandel DB. 1998. The impact of maternal drinking during and after pregnancy on the drinking of adolescent offspring. J Stud Alcohol. 1998 May;59(3):292-304.
Buscar en EHD Ref. / Resumen

Haddow JE, Palomaki GE, Allan WC, Williams JR, Knight GJ, Gagnon J, O'Heir CE, Mitchell ML, Hermos RJ, Waisbren SE, Faix JD, Klein RZ. 1999. Maternal thyroid deficiency during pregnancy and subsequent neuropsychological development of the child. N Engl J Med. Aug 19;341(8):549-55.
Buscar en EHD Ref. / Resumen

International Diabetes Federation. 2002. Experts reach consensus on causes of Type 2 diabetes. International Diabetes Federation Website. International Diabetes Federation.
Buscar en EHD Texto completo

Javaid MK, Crozier SR, Harvey NC, Gale CR, Dennison EM, Boucher BJ, Arden NK, Godfrey KM, Cooper C; Princess Anne Hospital Study Group. 2006. Maternal vitamin D status during pregnancy and childhood bone mass at age 9 years: a longitudinal study. Lancet. Jan 7;367(9504):36-43.
Buscar en EHD Ref. / Resumen

Langley K, Holmans PA, van den Bree MB, Thapar A. 2007. Effects of low birth weight, maternal smoking in pregnancy and social class on the phenotypic manifestation of Attention Deficit Hyperactivity Disorder and associated antisocial behaviour: investigation in a clinical sample. BMC Psychiatry. Jun 20;7:26.
Buscar en EHD Ref. / Resumen Texto completo

Linnet KM, Dalsgaard S, Obel C, Wisborg K, Henriksen TB, Rodriguez A, Kotimaa A, Moilanen I, Thomsen PH, Olsen J, Jarvelin MR. 2003. Maternal lifestyle factors in pregnancy risk of attention deficit hyperactivity disorder and associated behaviors: review of the current evidence. Am J Psychiatry. Jun;160(6):1028-40.
Buscar en EHD Ref. / Resumen Texto completo

Litonjua AA, Rifas-Shiman SL, Ly NP, Tantisira KG, Rich-Edwards JW, Camargo CA Jr, Weiss ST, Gillman MW, Gold DR. 2006. Maternal antioxidant intake in pregnancy and wheezing illnesses in children at 2 y of age. Am J Clin Nutr. Oct;84(4):903-11.
Buscar en EHD Ref. / Resumen Texto completo

Millichap JG. 2008. Etiologic classification of attention-deficit/hyperactivity disorder. Pediatrics. Feb;121(2):e358-65.
Buscar en EHD Ref. / Resumen Texto completo

Montgomery SM, Ekbom A. 2002. Smoking during pregnancy and diabetes mellitus in a British longitudinal birth cohort. BMJ. 324:26-27.
Buscar en EHD Ref. / Resumen Texto completo

Ong KK, Dunger DB. 2002. Perinatal growth failure: the road to obesity, insulin resistance and cardiovascular disease in adults. Best Pract Res Clin Endocrinol Metab. 16:191-207.
Buscar en EHD Ref. / Resumen Texto completo

Power C, Jefferis BJ. 2002. Fetal environment and subsequent obesity: a study of maternal smoking. Int J Epidemiol. 31:413-419.
Buscar en EHD Ref. / Resumen Texto completo

Salihu HM, Wilson RE. 2007. Epidemiology of prenatal smoking and perinatal outcomes. Early Hum Dev. Nov;83(11):713-20.
Buscar en EHD Ref. / Resumen Texto completo

Sokol RJ, Janisse JJ, Louis JM, Bailey BN, Ager J, Jacobson SW, Jacobson JL. 2007. Extreme prematurity: an alcohol-related birth effect. Alcohol Clin Exp Res. Jun;31(6):1031-7.
Buscar en EHD Ref. / Resumen

Spong CY. 2007. Prediction and prevention of recurrent spontaneous preterm birth. Obstet Gynecol. Aug;110(2 Pt 1):405-15.
Buscar en EHD Ref. / Resumen Texto completo

Van den Bergh BR, Marcoen A. 2004. High antenatal maternal anxiety is related to ADHD symptoms, externalizing problems, and anxiety in 8- and 9-year-olds. Child Dev. Jul-Aug;75(4):1085-97.
Buscar en EHD Ref. / Resumen Texto completo

Wakschlag LS, Lahey BB, Loeber R, Green SM, Gordon RA, Leventhal BL. 1997. Maternal smoking during pregnancy and the risk of conduct disorder in boys. Arch Gen Psychiatry. Jul;54(7):670-6.
Buscar en EHD Ref. / Resumen

Williams JL, Abelman SM, Fassett EM, Stone CE, Petrini JR, Damus K, Mulinare J. 2006. Health care provider knowledge and practices regarding folic acid, United States, 2002-2003. Matern Child Health J. Sep;10(5 Suppl):S67-72.
Buscar en EHD Ref. / Resumen Texto completo

Williams LJ, Rasmussen SA, Flores A, Kirby RS, Edmonds LD. 2005. Decline in the prevalence of spina bifida and anencephaly by race/ethnicity: 1995-2002. Pediatrics. Sep;116(3):580-6.
Buscar en EHD Ref. / Resumen Texto completo

World Health Organization. 2002. The world health report 2002 - Reducing Risks, Promoting Healthy Life. WHO Website. World Health Organization.
Buscar en EHD Texto completo

von Kries R, Toschke AM, Koletzko B, Slikker W, Jr. 2002. Maternal smoking during pregnancy and childhood obesity. Am J Epidemiol. 156:954-961.
Buscar en EHD Ref. / Resumen Texto completo