PREMATURE BIRTH AND DISEASE PROGRAMMING. CONTRIBUTION OF NEONATAL INTENSIVE CARE

Abstract

Modern clinical practice for the care of the prematurely born infants has markedly improved their rates of survival. Since the clinical follow-up is of short duration, only limited data are available to relate diseases in adult life to events and interventions in the neonatal period. The major factors that could have a programming (which could lead to disease) effect include: 1) intrauterine growth restriction; 2) interruption of pregnancy with change in oxygenation and water environment; 3) nutritional and pharmacological protocols for clinical care. The available clinical and experimental data are discussed in the context of perturbations in DNA methylation and its possible programming effects. The consequences of antenatal and postnatal administration of glucocorticoids are discussed. We speculate that premature interruption of pregnancy and neonatal interventions by affecting DNA methylation may cause programming effects on the immature baby.

Keywords

• prematurity
• disease programming
• dna methylation