Restricción de crecimiento fetal, epigenética y transmisión trans generacional de las enfermedades crónicas y la pobreza

The set of chronic diseases traditionally referred to as “non-communicable” (metabolic syndrome, diabetes, obesity, hypertension, insulin resistance, etc.) could arise early in fetal life and early childhood through activation of epigenetic mechanisms, not yet sufficiently known but clearly not involve structural changes in the gene sequences. This article attempts to overhaul the knowledge available from a perinatal perspective. Furthermore, a hypothesis for which there would be the possibility of trans-generational transmission of chronic diseases in the context of poverty and social exclusion is proposed. Epigenetic activation of the so-called “thrifty genotype” is most prevalent way violated the most vulnerable and socio-economic sectors and tend to increase the risk in their offspring. It is proposed that these chronic diseases are actually socially communicable and evaluated how this knowledge will change the clinical management of intrauterine growth restriction. Finally the windows of opportunity that public policies have to reverse this vicious cycle are analyzed. (Horiz Med 2013; 13(4): 45-53)