Respiratory Outcomes in Preterm Infants by Anna Maria Hibbs & Marianne S. Muhlebach

Author:Anna Maria Hibbs & Marianne S. Muhlebach
Language: eng
Format: epub
Publisher: Springer International Publishing, Cham

Developmental Origins of Health and Disease Hypothesis (DOHAD)

This hypothesis states that in utero events at critical times can reprogram an individual to respond better to current adverse circumstances, but at a cost of later maladaptive responses. Speculatively, this may account for the pulmonary hypertensive responses in preterm survivors described earlier. Unsurprisingly, the best data come from murine models; tobacco smoke exposure of pregnant dams leads to enhanced allergic responses postnatally in the offspring [113], and neonatal hyperoxia alters pulmonary immune responses and oxidative stress [114, 115]. It is possible, but speculative, that the increased oxidative stress in human preterm survivors (above) may be a DOHAD manifestation. Clearly, more research is needed, but the clinician should be alert to the possibility that these survivors may react differently to adverse later life insults.

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