Petit poids de naissance et risque métabolique chez l'adulte

Being born small for gestational age (SGA) corresponds to an epidemiological definition that covers a broad range of clinical conditions. SGA individuals have an increased risk of developing later in life type 2 diabetes, metabolic syndrome and cardiovascular diseases. The mismatch between a poor intrauterine environment and more favorable postnatal conditions would result in metabolic changes prone to the development of insulin resistance. The pathway to the metabolic diseases encompasses both fetal and postnatal catch-up growth with the concomitant adaptation of insulin sensitivity and body composition. Catch-up growth is a physiological and adaptive process aimed at replacing the child on his/her own growth trajectory; it implies redistribution of the metabolic fluxes and restores the fat stores lost during the fetal growth restriction. Simultaneously, it may promote relative excess of fat mass, which in turns would generate insulin resistance. However, not all children born SGA will ultimately develop the metabolic complications. As of today, there are no intervention studies aiming at the prevention of the development of the metabolic complications during the first years of life.