Fetal Exposures and Adult Disease

Abstract The possibility that fetal exposures can have long-term health effects was dramatically demonstrated by the example of DES, which causes extensive reproductive damage and increased cancer risk among women exposed as fetuses. Another topic of great interest has been fetal nutrition and its association with subsequent cardiovascular health. David Barker proposed that undernutrition of the fetus “programs” fetal physiology in ways that increase later cardiovascular disease. This hypothesis is increasingly in doubt, with confounding by maternal cardiovascular conditions contributing most or all of the observed associations. There are other examples of fetal exposures that affect health, particularly neurodevelopment. Given the long latency between fetal exposures and later expression of disease, harmful effects from fetal exposures are not easily assessed and may easily be overlooked.