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DOHaD at the intersection of maternal immune activation and maternal metabolic stress: a scoping review

Published online by Cambridge University Press:  15 February 2017

J. A. Goldstein Open the ORCID record for J. A. Goldstein [Opens in a new window] ,
S. A. Norris  and
D. M. Aronoff
J. A. Goldstein
Affiliation:
Department of Pathology, Microbiology, and Immunology, Vanderbilt UniversityMedical Center, Nashville, Tennessee, United States of America
S. A. Norris
Affiliation:
Medical Research Council Developmental Pathways for Health Research Unit, University of the Witwatersrand, Johannesburg, South Africa
D. M. Aronoff*
Affiliation:
Department of Pathology, Microbiology, and Immunology, Vanderbilt UniversityMedical Center, Nashville, Tennessee, United States of America Department of Medicine, Vanderbilt UniversityMedical Center, Nashville, Tennessee, United States of America
*
*Address for correspondence: D. M. Aronoff, MD, 1161 21st Avenue South, A-2200 Medical Center North, Nashville, TN 37232-2582, USA. (Email: d.aronoff@vanderbilt.edu)
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Abstract

The prenatal environment is now recognized as a key driver of non-communicable disease risk later in life. Within the developmental origins of health and disease (DOHaD) paradigm, studies are increasingly identifying links between maternal morbidity during pregnancy and disease later in life for offspring. Nutrient restriction, metabolic disorders during gestation, such as diabetes or obesity, and maternal immune activation provoked by infection have been linked to adverse health outcomes for offspring later in life. These factors frequently co-occur, but the potential for compounding effects of multiple morbidities on DOHaD-related outcomes has not received adequate attention. This is of particular importance in low- or middle-income countries (LMICs), which have ongoing high rates of infectious diseases and are now experiencing transitions from undernutrition to excess adiposity. The purpose of this scoping review is to summarize studies examining the effect and interaction of co-occurring metabolic or nutritional stressors and infectious diseases during gestation on DOHaD-related health outcomes. We identified nine studies in humans – four performed in the United States and five in LMICs. The most common outcome, also in seven of nine studies, was premature birth or low birth weight. We identified nine animal studies, six in mice, two in rats and one in sheep. The interaction between metabolic/nutritional exposures and infectious exposures had varying effects including synergism, inhibition and independent actions. No human studies were specifically designed to assess the interaction of metabolic/nutritional exposures and infectious diseases. Future studies of neonatal outcomes should measure these exposures and explicitly examine their concerted effect.

Keywords

child growth and healthobesityoutcome/systempregnancy
Type
Review
Information
Journal of Developmental Origins of Health and Disease , Volume 8 , Issue 3 , June 2017 , pp. 273 - 283
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Copyright
© Cambridge University Press and the International Society for Developmental Origins of Health and Disease 2017 

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