Aperçu: G.M.
Le
rythme rapide du développement du fœtus dépasse de loin toutes les
autres étapes de la vie et, par conséquent, les influences
environnementales peuvent modifier profondément le cours du
développement. Le
stress pendant la période prénatale, y compris la malnutrition et
l'inflammation, influe sur le développement neurologique maternel et
foetal avec des conséquences à long terme pour la santé physique et
mentale de la mère et de son enfant. Une
conséquence primaire de la malnutrition maternelle, de l'inflammation
et d'autres sources de stress prénatal est un mauvais résultat, comme la
prématurité ou la restriction de la croissance.
L'amélioration
de la santé maternelle et infantile nécessite des interventions qui
commencent avant la grossesse et se poursuivent tout au long de la
gestation et dans la période post-partum. Ces
interventions pourraient inclure l'intention de grossesse,
l'alimentation maternelle, la santé / soins médicaux, la santé mentale
et la fourniture d'un soutien social. Cet article traite de l'impact de la nutrition maternelle et de
l'inflammation lors de la préconception et de la grossesse chez les
femmes vivant dans des milieux à faible ressources, en mettant l'accent
sur les lacunes importantes en matière de connaissances qui doivent être
abordées pour guider les décisions politiques aux niveaux
local, régional et mondial.
Pediatrics. 2017 Apr;139(Suppl 1):S38-S49. doi: 10.1542/peds.2016-2828F.
Neurodevelopment: The Impact of Nutrition and Inflammation During Preconception and Pregnancy in Low-Resource Settings
Vohr BR1,2, Poggi Davis E3,4, Wanke CA5, Krebs NF6.
Author information
- 1
- Neonatal Follow-up Program, Women & Infants Hospital, Providence, Rhode Island; bvohr@wihri.org.
- 2
- Department of Pediatrics, Brown University, Providence, Rhode Island.
- 3
- Department of Psychology, University of Denver, Denver, Colorado.
- 4
- Department of Psychiatry, University of California Irvine, Irvine, California.
- 5
- Department of Public Health and Community Medicine, Tufts University, Medford, Massachusetts; and.
- 6
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado.
Abstract
The
rapid pace of fetal development by far exceeds any other stage of the
life span, and thus, environmental influences can profoundly alter the
developmental course. Stress during the prenatal period, including
malnutrition and inflammation, impact maternal and fetal
neurodevelopment with long-term consequences for physical and mental
health of both the mother and her child. One primary consequence of
maternal malnutrition, inflammation, and other sources of prenatal
stress is a poor birth outcome, such as prematurity or growth
restriction. These phenotypes are often used as indications of prenatal
adversity. In fact, the original evidence supporting the fetal
programming hypothesis came from studies documenting an association
between birth phenotype and the development of subsequent physical and
mental health problems. Fetal growth restriction in both term and
preterm infants is associated with neonatal morbidities and a wide
variety of behavioral and psychological diagnoses in childhood and
adolescence, including attention-deficit/hyperactivity disorder, anxiety, depression, internalizing and thought problems, poor social skills, and autism spectrum disorder.
Improving maternal-child health requires interventions that begin
before pregnancy and continue throughout gestation and into the
postpartum period. Such interventions might include supporting pregnancy
intention, maternal nutrition, health/medical care, mental health, and
providing social support. This article discusses the impact of maternal
nutrition and inflammation during preconception and pregnancy among
women living in low-resource settings, with an emphasis on key knowledge
gaps that need to be addressed to guide program and policy decisions at
local, regional and global levels.
Copyright © 2017 by the American Academy of Pediatrics.
- PMID:28562247
- DOI:10.1542/peds.2016-2828F
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