Rev. Méd. RosaRio 88: 105, 2022
RESÚMENES DE PUBLICACIONES
COMPLEXPERINATALSYNDROMESAFFECTINGEARLYHUMANGROWTHANDDEVELOPMENT:
ISSUES TO CONSIDER TO UNDERSTAND THEIR AETIOLOGY AND POSTNATAL EFFECTS
1
2
3,4
3,5,6
*, Michelle FeRnandes ,
RobeRto FRenquelli , MaRc RatcliFF , JiMena villaR de onis
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6
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3,6
FeRnando c. baRRos , Jane e. hiRst , aRis t. PaPageoRghiou , stePhen h. Kennedy and
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Jose villaR
1
Master Program in Child Psychoanalysis and Neuropsychological, Developmental Psychology Unit, Faculty of Psychology,
2
National University of Rosario, Rosario, Argentina, Faculty of Psychology and Educational Science, Centre Jean Piaget,
University of Geneva, Geneva, Switzerland, Oxford Maternal & Perinatal Health Institute, Green Templeton College,
University of Oxford, Oxford, United Kingdom, Geneva Foundation for Medical Education and Research, Geneva,
Switzerland, MRC Lifecourse Epidemiology Centre, Human Development and Health Academic Unit, Department of
Paediatrics, Faculty of Medicine, University of Southampton, Southampton, United Kingdom, Nuffield Department of
Women’s & Reproductive Health, University of Oxford, Oxford, United Kingdom, Post Graduate Course on Health in
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4
5
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7
the Vital Cycle, Universidade Católica de Pelotas, Pelotas, Brazil
Complex perinatal syndromes (CPS) affecting pregnancy and childhood, such as preterm birth, and intra-
and extra-uterine growth restriction, have multiple, diverse contexts of complexity and interaction that determine
the short- and long-term growth, health and development of all human beings. Early in life, genetically-guided
somatic and cerebral development occurs alongside a psychism “in statu nascendi,” with the neural structures
subjected to the effects of the intra- and extra-uterine environments in preparation for optimal postnatal
functioning. Different trajectories of fetal cranial and abdominal growth have been identified before 25 weeks’
gestation, tracking differential growth and neurodevelopment at 2 years of age. Similarly, critical time-windows
exist in the first 5–8 months of postnatal life because of interactions between the newborn and their environment,
mother/care-givers and feeding practices. Understanding these complex relational processes requires abandoning
classical, linear and mechanistic interpretations that are placed in rigid, artificial biological silos. Instead, we need to
conduct longitudinal, interdisciplinary research and integrate the resulting new knowledge into clinical practice. An
ecological-systemic approach is required to understand early human growth and development, based on a dynamic
multidimensional process from the molecular or genomic level to the socio-economic- environmental context. For
this, we need theoretical and methodological tools that permit a global understanding of CPS, delineating temporal
trajectories and their conditioning factors, updated by the incorporation of new scientific discoveries. e potential
to optimize human growth and development across chronological age and geographical locations – by implementing
interventions or “treatments” during periods of greatest instability or vulnerability – should be recognized. Hence, it
is imperative to take a holistic view of reproductive and perinatal issues, acknowledging at all levels the complexity
and interactions of CPS and their sensitive periods, laying the foundations for further improvements in growth and
development of populations, to maximize global human potential. We discuss here conceptual issues that should
be considered for the development and implementation of such a strategy aimed at addressing the perinatal health
problems of the new millenium.
Keywords: complex perinatal syndromes, human growth and development, preterm birth, extra-uterine growth
restriction, intra-uterine growth restriction, pregnancy and childhood
Front Neurosci 16:856886, 2022
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