Perinatal determinants of adult cardiovascular disease and cancer.

Interest in perinatal factors, especially birthweight, as determinants of adult-onset diseases has been steadily growing. Low birthweight has been associated with increased risk of cardiovascular disease, and high birthweight has been linked to higher risk of breast and possibly other cancers. Most mechanistic hypotheses that have been advanced to explain the empirical evidence linking perinatal conditions to adult-life disease in humans have invoked modulation of physiological processes by exogenous factors or poorly specified "programming" during fetal life. A form of programming that has a strong biological foundation and has recently been suggested for further study is genomic imprinting, which involves non-permanent DNA modifications and allows for influences that span three generations. The subject of the perinatal origin of adult-onset disease has profound implications and a large and reliable body of evidence needs to be assembled for biological theories to be validly evaluated against.