Low Birth Weight, A Marker of Intrauterine Stress and Adult Disease

  • Paolo F. Rinaudo
  • Luisa Delle Piane
  • Alberto Revelli


Embryos and fetuses show a remarkable plasticity during early development and, consequently, can be molded by the environment. Causes of in utero stress are diverse and range from inappropriate diet to toxic exposure (such as tobacco or alcohol), infection, and diseases complicating pregnancy. By adapting to a limited supply of nutrients or to an altered milieu, the developing organism trades off the development of nonessential organs, such as kidney (nephron mass) and pancreas (beta cell mass), in favor of more essential organs such as the brain. The exact mechanisms leading to altered programming are unknown but include abnormal placentation, increased oxidative stress, inappropriate activation of the adrenal axis and epigenetic changes. The short-term effect of these insults is a fetus that has not reached his growth potential. The long-term effect of these developmental adaptations is a predisposition to chronic diseases such as cardiovascular disease, hypertension, stroke, and diabetes. Given the importance of uterine life for future health, clinicians need to include markers of uterine stress, such as low birth weight (LBW), into a patient medical history. Special attention should be paid to the metabolic intrauterine environment, avoiding any adverse stressor that could affect fetal growth with long-standing postnatal metabolic consequences. Medical interventions aimed at improving pregnancy health can have long-term benefit for the individual and the society and should be prioritized.


Birth Weight Fetal Growth Restriction Assist Reproductive Technique Nephron Number Abnormal Placentation 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



Adrenocorticotropic hormone


Assisted reproductive techniques


Corticotropin-releasing hormone


Developmental origin of health and disease


Extremely low birth weight




Intra-cytoplasmic sperm injection


Insulin-like growth factor 1


Intrauterine growth restriction


In vitro fertilization


Low birth weight


Non-insulin-dependent diabetes mellitus


Progesterone-induced blocking factor


Reactive oxygen species


Small for gestational age


Very low birth weight


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Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  • Paolo F. Rinaudo
    • 1
  • Luisa Delle Piane
    • 2
  • Alberto Revelli
    • 2
  1. 1.Reproductive Endocrinology and InfertilityUniversity of California San FranciscoSan FranciscoUSA
  2. 2.Reproductive Medicine and IVF UnitUniversity of TurinTorinoItaly

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