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Prenatal and postnatal nutrition for future health.

DOI:10.1097/MCO.0000000000000053 Traditionally, nutrition of the newborn infant and, to a lesser extent, nutrition of toddlers and older children were considered important for proper growth and immediate functions such as immune defense. However, in the recent years, there is increasing awareness of the importance of nutrition before and during pregnancy and in early childhood, also for long-term health during later childhood and adulthood up to old age. The pediatric section of this issue of Current Opinion in Clinical Nutrition and Metabolism mirrors these findings with articles on the effects of nutrition in pregnancy, on the impact of the infant and child nutrition, as well as articles discussing the continuity between pregnancy and postnatal nutrition as demonstrated in the studies looking at the combined effect of probiotics supplementation during pregnancy and after birth. Bhutta et al. (pp. 249–254) discuss the impact of intrauterine growth restriction (IUGR) on long-term health. They remind us that almost 30–50% of extremely premature neonates are IUGR, and maternal comorbidities like gestational diabetes, hypertension as well as poor maternal nutrition are known risk factors that should be identified and properly treated. Secondly, they summarize both short-term and long-term health consequences of IUGR and suggest the mechanisms that will explain these consequences, including well known metabolic pathways such as insulin resistance and emerging concepts on the role of the adipose tissue in linking poor fetal growth to subsequent adult disease. Although it is unknown whether IUGR itself is the culprit or responses to IUGR after birth, it is clear that efforts should focus on detecting IUGR early and institute proper surveillance. Although appropriate serum biomarkers are yet to be identified, recent data on Doppler velocimetry of the umbilical and fetal arteries are promising, and suggest that reliable prediction of IUGR is feasible and may prove to be important in reducing the short-term and long-term morbidity and mortality. Hiersch and Yogev (pp. 255–260) discuss the importance of hyperglycemia during pregnancy and provide recent data on the relationship between hyperglycemia during pregnancy and fetal outcomes, mainly in the form of excessive fetal growth.