The University of Southampton
University of Southampton Institutional Repository

Complex perinatal syndromes affecting early human growth and development: issues to consider to understand their aetiology and postnatal effects

Complex perinatal syndromes affecting early human growth and development: issues to consider to understand their aetiology and postnatal effects
Complex perinatal syndromes affecting early human growth and development: issues to consider to understand their aetiology and postnatal effects

Complex perinatal syndromes (CPS) affecting pregnancy and childhood, such as preterm birth, and intra- and extra-uterine growth restriction, have multiple, diverse contexts of complexity and interaction that determine the short- and long-term growth, health and development of all human beings. Early in life, genetically-guided somatic and cerebral development occurs alongside a psychism “in statu nascendi,” with the neural structures subjected to the effects of the intra- and extra-uterine environments in preparation for optimal postnatal functioning. Different trajectories of fetal cranial and abdominal growth have been identified before 25 weeks’ gestation, tracking differential growth and neurodevelopment at 2 years of age. Similarly, critical time-windows exist in the first 5–8 months of postnatal life because of interactions between the newborn and their environment, mother/care-givers and feeding practices. Understanding these complex relational processes requires abandoning classical, linear and mechanistic interpretations that are placed in rigid, artificial biological silos. Instead, we need to conduct longitudinal, interdisciplinary research and integrate the resulting new knowledge into clinical practice. An ecological-systemic approach is required to understand early human growth and development, based on a dynamic multidimensional process from the molecular or genomic level to the socio-economic-environmental context. For this, we need theoretical and methodological tools that permit a global understanding of CPS, delineating temporal trajectories and their conditioning factors, updated by the incorporation of new scientific discoveries. The potential to optimize human growth and development across chronological age and geographical locations – by implementing interventions or “treatments” during periods of greatest instability or vulnerability – should be recognized. Hence, it is imperative to take a holistic view of reproductive and perinatal issues, acknowledging at all levels the complexity and interactions of CPS and their sensitive periods, laying the foundations for further improvements in growth and development of populations, to maximize global human potential. We discuss here conceptual issues that should be considered for the development and implementation of such a strategy aimed at addressing the perinatal health problems of the new millenium.

complex perinatal syndromes, extra-uterine growth restriction, human growth and development, intra-uterine growth restriction, pregnancy and childhood, preterm birth
1662-4548
Frenquelli, Roberto
6a3f4fa8-7bc0-49ed-90fd-0ff1fc193fcd
Ratcliff, Marc
405876da-3108-4cdf-8c15-b460e73e8aef
Viller de Onis, Jimena
2463078b-cadc-467f-aee7-04ef4e71ff74
Fernandes, Michelle
16d62e60-ae8e-455f-88d3-88e778253b4a
Barros, Fernando C.
04c82886-8960-4f13-8990-2214ddd4a9e8
Hirst, Jane E.
e29393b2-6011-4a61-b298-356ad59663ec
Papageorghiou, Aris T.
48974657-d399-4f7f-8b8b-5b9174b8fefa
Kennedy, Stephen H.
ccbde0f7-ca8b-43d1-9810-be6924720401
Frenquelli, Roberto
6a3f4fa8-7bc0-49ed-90fd-0ff1fc193fcd
Ratcliff, Marc
405876da-3108-4cdf-8c15-b460e73e8aef
Viller de Onis, Jimena
2463078b-cadc-467f-aee7-04ef4e71ff74
Fernandes, Michelle
16d62e60-ae8e-455f-88d3-88e778253b4a
Barros, Fernando C.
04c82886-8960-4f13-8990-2214ddd4a9e8
Hirst, Jane E.
e29393b2-6011-4a61-b298-356ad59663ec
Papageorghiou, Aris T.
48974657-d399-4f7f-8b8b-5b9174b8fefa
Kennedy, Stephen H.
ccbde0f7-ca8b-43d1-9810-be6924720401

Frenquelli, Roberto, Ratcliff, Marc, Viller de Onis, Jimena, Fernandes, Michelle, Barros, Fernando C., Hirst, Jane E., Papageorghiou, Aris T. and Kennedy, Stephen H. (2022) Complex perinatal syndromes affecting early human growth and development: issues to consider to understand their aetiology and postnatal effects. Frontiers in Neuroscience, 16, [856886]. (doi:10.3389/fnins.2022.856886).

Record type: Article

Abstract

Complex perinatal syndromes (CPS) affecting pregnancy and childhood, such as preterm birth, and intra- and extra-uterine growth restriction, have multiple, diverse contexts of complexity and interaction that determine the short- and long-term growth, health and development of all human beings. Early in life, genetically-guided somatic and cerebral development occurs alongside a psychism “in statu nascendi,” with the neural structures subjected to the effects of the intra- and extra-uterine environments in preparation for optimal postnatal functioning. Different trajectories of fetal cranial and abdominal growth have been identified before 25 weeks’ gestation, tracking differential growth and neurodevelopment at 2 years of age. Similarly, critical time-windows exist in the first 5–8 months of postnatal life because of interactions between the newborn and their environment, mother/care-givers and feeding practices. Understanding these complex relational processes requires abandoning classical, linear and mechanistic interpretations that are placed in rigid, artificial biological silos. Instead, we need to conduct longitudinal, interdisciplinary research and integrate the resulting new knowledge into clinical practice. An ecological-systemic approach is required to understand early human growth and development, based on a dynamic multidimensional process from the molecular or genomic level to the socio-economic-environmental context. For this, we need theoretical and methodological tools that permit a global understanding of CPS, delineating temporal trajectories and their conditioning factors, updated by the incorporation of new scientific discoveries. The potential to optimize human growth and development across chronological age and geographical locations – by implementing interventions or “treatments” during periods of greatest instability or vulnerability – should be recognized. Hence, it is imperative to take a holistic view of reproductive and perinatal issues, acknowledging at all levels the complexity and interactions of CPS and their sensitive periods, laying the foundations for further improvements in growth and development of populations, to maximize global human potential. We discuss here conceptual issues that should be considered for the development and implementation of such a strategy aimed at addressing the perinatal health problems of the new millenium.

Text
fnins-16-856886
Available under License Creative Commons Attribution.
Download (2MB)

More information

Accepted/In Press date: 11 March 2022
Published date: 18 April 2022
Additional Information: Funding Information: This work was supported by the grant OPP49038 from the Bill & Melinda Gates Foundation to the University of Oxford. The funder played no role in the study design; collection, analysis, and interpretation of data; the writing of the report; or the decision to submit the article for publication. Publisher Copyright: Copyright © 2022 Frenquelli, Ratcliff, Villar de Onis, Fernandes, Barros, Hirst, Papageorghiou, Kennedy and Villar. Copyright: Copyright 2022 Elsevier B.V., All rights reserved.
Keywords: complex perinatal syndromes, extra-uterine growth restriction, human growth and development, intra-uterine growth restriction, pregnancy and childhood, preterm birth

Identifiers

Local EPrints ID: 457181
URI: http://eprints.soton.ac.uk/id/eprint/457181
ISSN: 1662-4548
PURE UUID: fc57823d-c3cc-4b1e-80a1-2c3bd2b9df60
ORCID for Michelle Fernandes: ORCID iD orcid.org/0000-0002-0051-3389

Catalogue record

Date deposited: 25 May 2022 17:14
Last modified: 17 Mar 2024 04:10

Export record

Altmetrics

Contributors

Author: Roberto Frenquelli
Author: Marc Ratcliff
Author: Jimena Viller de Onis
Author: Michelle Fernandes ORCID iD
Author: Fernando C. Barros
Author: Jane E. Hirst
Author: Aris T. Papageorghiou
Author: Stephen H. Kennedy

Download statistics

Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.

View more statistics

Atom RSS 1.0 RSS 2.0

Contact ePrints Soton: eprints@soton.ac.uk

ePrints Soton supports OAI 2.0 with a base URL of http://eprints.soton.ac.uk/cgi/oai2

This repository has been built using EPrints software, developed at the University of Southampton, but available to everyone to use.

We use cookies to ensure that we give you the best experience on our website. If you continue without changing your settings, we will assume that you are happy to receive cookies on the University of Southampton website.

×