Effects of maternal undernutrition on lung growth and development in the offspring

Maternal undernutrition during pregnancy causes fetal growth restriction. Alterations in fetal nutritional status may result in developmental adaptations that permanently change the structure and physiology of the offspring, thus predisposing individuals to pulmonary, endocrine, and cardiovascular diseases in adult life. This phenomenon, termed "fetal programming", has led to the theory of "fetal origins of adult disease". Maternal undernutrition may have significant effects on the developing fetal lung, which undergoes rapid cellular multiplication and differentiation shortly before birth. Intrauterine growth restriction (IUGR) is an important risk factor for both early and late postnatal respiratory morbidity. Lung growth and development and later function can be affected by fetal growth restriction. Intrauterine growth restriction can be caused by maternal, placental, or fetal factors that affect the intrauterine environment. The exact pulmonary consequences linked to each of these specific causes are poorly understood. We have found that inadequate maternal dietary intake during late gestation altered the development of the lung structure (reduced alveolar surface area and volume fraction) and expression of lung growth factors in the postnatal period. Numerous studies have been performed to investigate the effects as well as the exact mechanism of action of maternal undernurition. The purpose of this review is to evaluate these studies in order to elucidate the harmful effects of maternal undernutrition on lung growth and development in the offspring. Subsequently, the mechanism by which maternal undernutrition induces fetal programming on lung growth will be discussed.