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Abstract
Environmental effects on the materno-foetal interaction determine birth outcomes that
predict health over the lifespan. Thus, maternal undernutrition or stress associate
with low birth weight, leading to an increased risk of metabolic and cardiovascular
illness in the offspring. We argue that these effects are, in part, mediated by direct
and indirect effects on the hypothalamic-pituitary-adrenal (HPA) axis such that (i)
the effect of maternal adversity on foetal growth is mediated by adrenal glucocorticoids
and (ii) environmental adversity alters maternal physiology and behaviour, which then
programs HPA activity in the offspring.