HJNO Jan/Feb 2022

48 JAN / FEB 2022 I  HEALTHCARE JOURNAL OF NEW ORLEANS COLUMN INSURANCE Our DNA is the predictor of diseases and disorders we inherit. However, “fetal origins” asserts in utero is the most sig- nificant phase of our development, influ- encing the permanent wiring of the brain as well as the functions of organs such as the heart, liver and pancreas. In short, the conditions we experience in the womb in- fluence everything from our physiology to our metabolism and appetite, to our tem- perament and aptitude. Numerous studies have linked fetal origins to cancer, cardio- vascular disease, allergies, asthma, hyper- tension, diabetes, obesity, mental illness and to arthritis, osteoporosis and cognitive decline. 1 FROM THE WOMB TO THE CRADLE Focusing on Maternal Health for the Sake of a Newborn’s Adult Health We are who we are — anxious, outgoing, diabetic, overweight, healthy. But why?What makes someone prone to nervousness, anemia or asthma? Why is it that some of us will suffer from high blood pressure, schizophrenia or heart attacks, and some won’t? The prevailing answer is genetics. Consider the quality and quantity of nutrition provided in the womb; air pollu- tion, medications consumed or infections experienced during gestation; the mother’s overall health and well-being; her level of emotional stress and psychological sta- bility during her pregnancy. These all add up to factors that shape a person as a child and as an adult. Some may envision this concept in the form of enriching the fetus by playing Bach or reading poetry aloud to a pregnant belly. But the real impact that occurs in utero is infinitely more essential and life-altering and is incorporated into the actual physiology of the baby. Mater- nal contributions from the outside world are converted into biological information by the fetus in its “inside world.” Rather than absorbing a piano sonnet, the fetus is fielding much more complex and con- sequential questions around its ultimate survival: will its environment be abundant or meager?Will it be safe and protected, or will it be in a continual fight-or-flight re- sponse?The way in which it answers those questions has lifelong mental and physical repercussions.1 In an unhealthy or poten- tially abnormal uterine environment, the fetus adapts by expressing a phenotype or trait that promotes its survival and that persists throughout adulthood and across generations. 2