 ,            1. T         ,,              .12                w                 ,        . T,            w         .1


                    .         ,   ,  , .,      disturbances (in utero) is proving capable of reducing the risk of future illness.14


T    w               w          . T      ,       ,       w,           .          ,     ,            w . Clarifying epigenetic regulators and how to modify them will improve pregnancy outcomes and the ability to treat and prevent disorders that emerge much later in life, even as their origins begin very early in life.


Epigenetics T               w  w   .                      .1


Figure 1 igure . etal plasticit. Maternal stress, exposure to environmental toxins, and nutritional deciencies make up a signicant portion of the fetal exposome and drive epigenetic expression and organogenesis. Fetal plasticity is modied through a altered cell number and sie given nutrient or oxygen deprivation, b changes in gene expression through altered methylation and acetylation, c cellular and metabolic function such as neurotransmitter expression and adipose leptin secretion. All of these changes have lasting effects on the child’s lifelong organ function, metabolism and later susceptibility to disease.


T,         , , , , ,   ,      w    . T              w      w     .                  .  w    w        before pregnancy      


176


   w        . T               w.              w   ,         . T              ,     ,   ,             .1


ene unction   rie eiew       w   . T w        how             . T w          .


        w       w            . T     ,     .        w             .  w     ,      .           ,   w      


    THE ORIGINAL INTERNIST  214   


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