Abordaje obstétrico integral de la prematurez y restricción del crecimiento fetal y su relación con las enfermedades crónicas del adulto

Leonel Briozzo; Stephanie Viroga

doi:10.29193/RMU.36.1.9

Leonel Briozzo Uruguay, Universidad de la República, Facultad de Medicina, Centro Hospitalario Pereira Rossell, Clínica Ginecotocológica A, Profesor Titular.
Stephanie Viroga Uruguay, Universidad de la República, Facultad de Medicina, Centro Hospitalario Pereira Rossell, Clínica Ginecotocológica A, Profesora Adjunta.

DOI: https://doi.org/10.29193/RMU.36.1.9

Keywords: FETAL GROWTH RETARDATION, PREMATURE BIRTH, CHRONIC DISEASES, EPIGENOMICS

Abstract

Preterm birth and growth restriction are obstetric syndromes which share etiopathogenic and pathophysiological mechanisms that often interact and feed from each other. Etiologically, they may be classified into inflammation, maternal stress, low socio-economic background and vulnerability of rights, endocrine disruptors, diet and microbiota alterations and vascular conditions, depending on specific conditions. These conditions, either in isolation or more often combined, create an unfavorable environment for the development of pregnancy, causing specific effects such as maternal immune response that may be mediated by infections, the activation of the hypothalamic-pituitary-adrenal (HPA) axis, drop in progesterone levels, dysbiosis, both intestinal and vaginal, and placental dysfunction caused by ageing. The unfavorable environment has an impact on the utero-feto-placental unit resulting in either preterm birth of growth restriction, depending on the predominance of the different responses. Regardless of the prevailing syndromic response, both preterm birth and growth restriction share the development of the thrifty pheno-genotype, essential for fetal survival. The cost of this epigenetic modulation is an increase in chronic adult diseases, which, conceptually, are transmissible diseases due to social vulnerability where these people live.

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Obstetric comprehensive approach to pre-term birth and growth restriction and its relationship with chronic adult diseases

Abstract

References

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