El bajo peso al nacer y la programación temprana de la vida, un problema de actualidad y del futuro

Rafael Jiménez García, Lázaro Alfonso Novo, Ronoel Peñalver Valdés, Sergio Santana Porbén

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El hecho de que el desarrollo fetal pueda ser un factor influyente en el desarrollo humano durante todo el ciclo de la vida ha sido explorado desde la primera mitad del siglo XX, cuando Kermack y otros analizan las tasas históricas de mortalidad en Gran Bretaña y Suiza, y observan que la expectativa de vida estaba determinada por las condiciones existentes durante las etapas tempranas de la vida. Los estudios de Forsdhal, en 1977, determinaron como factor de riesgo cardiovascular los estados de pobreza, seguidos de prosperidad durante la infancia y la adolescencia. Estas observaciones conllevaron a Barker a conformar su hipótesis acerca de la relación entre el bajo peso al nacer y el riesgo cardiovascular, la resistencia insulínica y la diabetes tipo II en la adultez. Aunque no se ha podido demostrar una relación causal única entre el bajo peso al nacer y el desarrollo de las enfermedades crónicas no transmisibles (siendo esta una relación multicausal, tanto los estudios in vitro como in vivo), han demostrado que un medio intrauterino deficiente, independiente de su causa, puede incrementar el riesgo de padecer esas enfermedades, al igual de que si persiste el medio adverso durante la infancia y la adolescencia (estados nutrimentales carenciales), se perpetúa el riesgo. El presente reporte tiene el objetivo de analizar algunos aspectos teóricos relacionados con la programación temprana de la vida y su relación con el desarrollo de las enfermedades crónicas no transmisibles, así como su importancia para el médico de familia y el pediatra general en la práctica médica diaria, encaminado a su prevención en etapas ulteriores del desarrollo humano.

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