Fetal origins of adult disease: intrauterine growth restriction as a risk factor

Background: Barker hypothesized that intrauterine growth restriction (IUGR) represents a risk factor for developing diseases during adulthood. Objective: To determine the relationship between IUGR and cardiovascular and endocrine diseases in adults reviewing studies published between January 1990 and December 2013. Method: A review of the literature in PubMed, MEDLINE, ProQuest and Ebsco database. Papers in Spanish, English or Portuguese were included. Results: Seven studies were included, one case-control and six cohort design. For diabetes two of three studies showed a significant association (RR=2.10, 95 percent CI 1.29-3.41; RR=1.43, 95 percent CI 0.53-3.87; HR=1.64, 95 percent CI 1.26-2.14) For hypertension, two found no statistically significant (RR=0.95, 95 percent CI 0.81-1.11 and RR=1.03, 95 percent CI 0.71-1.49). For coronary disease one showed significant association (HR=1.9, 95 percent CI 1.0 to 3.8). For obesity, a study found no relationship (men, RR=1.07, 95 percent CI 0.63-2.29; and women RR=1.07, 95 percent CI 0.53-2.14). For metabolic syndrome one study found significant association (RR=1.29, 95 percent CI 1.00-1.68). Conclusions: IUGR shows an inconsistent relationship with adult diseases in follow up observational researches. Longitudinal studies that corroborate the association between IUGR and adult diseases observed in some previous analyzes are needed.