Antenatal Origins of Health and Disease—A clinician's perspective

In the Western world, we usually count our age starting with zero at birth. Yet, the most important time span in our life, during which homeostatic set-points and trajectories for future health and disease are determined, is already behind us at the moment of delivery. Starting even before conception via effects on both gametes, exogenous and endogenous stimuli are deeply involved in the development of the zygote, all embryological stages, and the fetus by genetic and epigenetic mechanisms. What affects the pregnant mother may affect her growing fetus, and this includes nutrition, habits, environmental toxins, medications, and stress. The largely overlooked paternal part for the course of a pregnancy deserves additional attention. The different hormonal milieus for the growing female and male fetus and epigenetic process are crucial for their dimorphous development.

The science of the novel proposed term “Antenatal Origins of Health and Disease” is concerned with the impact of factors that may affect health and disease throughout life, including healthy aging, and may be inherited by future generations.

Understanding this concept means to understand that the care of a fetus needs to start even before its creation and includes an assessment of the health of both of its future parents.