Prenatal Programming of Hypertension and Kidney and Cardiovascular Disease

Epidemiologic studies have shown that small-for-gestational-age infants are at risk for hypertension, cardiovascular disease, chronic kidney disease, and premature death. This may result from intrauterine epigenetic adaptations that are beneficial to the fetus but result in phenotypic changes that are maladaptive in later life. The epidemiologic association between small-for-gestational-age infants and adverse outcomes in later life have been validated in controlled animal studies where maternal insults that result in small-for-gestational-age offspring result in the same adverse outcomes as found in humans. Of importance, recent studies find that premature infants are also at risk for hypertension and chronic kidney disease in later life.