Biological Reviews of the Cambridge Philosophical Society
Fetal growth and development is dependent upon the nutritional, hormonal and metabolic environment provided by the mother. Any disturbance in this environment can modify early fetal development with possible long-term outcomes as demonstrated by extensive work on 'programming'. Growth restriction resulting from a deficit in tissue/organ cell number (as measured by tissue DNA content) is irrecoverable. However, when the cell size (or cell protein content) is reduced, the effects on growth may not be permanent.
The epidemiological links observed between fetal and infant growth and impaired glucose tolerance in adult life that led to the formulation of the "thrifty phenotype" hypothesis have been confirmed by others in widely differing populations. The proposed nutritional basis of these links has been tested in an animal model in which rat dams were fed an isocaloric low-protein diet and the postweaning normally fed offspring were studied.
Epidemiological studies have revealed strong and reproducible links between indices of poor fetal, and possibly infant, growth and susceptibility to the development of glucose intolerance and insulin resistance syndrome in adult life. The 'thrifty phenotype' hypothesis has been proposed to explain these associations.
The modification of ageing by nutritional intervention is well recognised. Post-weaning diet restriction is the only widely reproducible method to slow ageing, but the effects of prenatal and preweaning diet restriction have been less well characterised. There is some evidence that diet restriction instituted in utero or shortly after birth may have an opposite effect and be associated with increased ageing, and recent work suggests that it may shorten lifespan.
We review the progress in testing the thrifty phenotype hypothesis. Many human epidemiological studies both by ourselves and others have confirmed and extended the original observations on which the hypothesis was based. We are not aware of any contradictory findings and we emphasise the strength of the association between birth weight and the subsequent development of the metabolic syndrome. We have worked extensively experimentally to test the hypothesis in a rat model in which pregnant and/or lactating dams are fed a diet moderately restricted in proteins.
Behavioral perinatology is as an interdisciplinary area of research that involves conceptualization of theoretical models and conduct of empirical studies of the dynamic time-, place-, and context-dependent interplay between biological and behavioral processes in fetal, neonatal, and infant life using an epigenetic framework of development. The biobehavioral processes of particular interest to our research group relate to the effects of maternal pre- and perinatal stress and maternal-placental-fetal stress physiology.
The author presents an overview (completed on September 15, 2001) of three issues involved in the ethics of human embryonic stem cell therapy: the ethical implications of some of the scientific issues involved, the specific ethical issues of the moral standing of the early human embryo and the problem of cooperation, and a consideration of two public policy issues: should the research go forward, and what kind of health care system should the United States adopt. The author argues that the public policy questions are the most important agenda.
In Life's Dominion Dworkin aims at defusing the controversy about abortion and euthanasia by redefining its terms. Basically it is not a dispute about the right to life, but about its value. Liberals should grant that human life has not only a personal, but also an intrinsic value; conservatives should accept the principle of toleration which requires to let people decide for themselves about matters of intrinsic value.
This case report presents a new association reaction and a new treatment for quadruplet pregnancies. The hypnotic interventions can increase clinical management of quadruplet pregnancy. It illustrates new insights into the treatment of quadruplet pregnancies, and it suggests useful future research.