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=== Barker Hypothesis ===
In the 1980s, [[David Barker (epidemiologist)|David Barker]] began a research study on this topic. The Barker Hypothesis, or [[Thrifty phenotype]], forms the basis for much of the research conducted on fetal programming. This hypothesis states that if the fetus is exposed to low nutrition, it will adapt to that particular environment. Nutrients are diverted towards the development of the heart, brain, and other essential organs of the fetus. The body also undergoes metabolic alterations that ensure survival in spite of low nutrition but may cause problems in situations with normal or high nutrition.<ref>{{cite journal | vauthors = Remacle C, Bieswal F, Reusens B | title = Programming of obesity and cardiovascular disease | journal = International Journal of Obesity and Related Metabolic Disorders | volume = 28 Suppl 3 | issue = S3 | pages = S46–53 | date = November 2004 | pmid = 15543219 | doi = 10.1038/sj.ijo.0802800 | doi-access = free }}</ref> This leads to increased risk of [[metabolic syndrome]].
== Nutritional status ==
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== Hormonal influence ==
A delicate balance of hormones during pregnancy is regarded as being highly relevant to fetal programming and may significantly influence the outcome on the offspring.<ref name="Hoffman_2016">{{cite journal | vauthors = Hoffman MC | title = Stress, the Placenta, and Fetal Programming of Behavior: Genes' First Encounter With the Environment | journal = The American Journal of Psychiatry | volume = 173 | issue = 7 | pages = 655–7 | date = July 2016 | pmid = 27363547 | doi = 10.1176/appi.ajp.2016.16050502 | doi-access = free }}</ref> Placental endocrine transfer from the mother to the developing fetus could be altered by the mental state of the mother, due to affected [[glucocorticoid]] transfer that takes place across the placenta.<ref name="Hoffman_2016" />
=== Thyroid ===
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==== Depression ====
Maternal depression poses one of the greatest risks for increased vulnerability to adverse outcomes for a baby that is developing in the uterus, especially in terms of susceptibility to a variety of psychological conditions.<ref name="Davis_2018">{{cite journal | vauthors = Davis EP, Hankin BL, Swales DA, Hoffman MC | title = An experimental test of the fetal programming hypothesis: Can we reduce child ontogenetic vulnerability to psychopathology by decreasing maternal depression? | journal = Development and Psychopathology | volume = 30 | issue = 3 | pages = 787–806 | date = August 2018 | pmid = 30068416 | doi = 10.1017/S0954579418000470 | pmc = 7040571 }}</ref> Mechanisms that may explain the connection between maternal depression and the offspring's future health are mostly unclear and form a current area of active research.<ref name="Davis_2018" /> Genetic inheritance that may be rendering the child more susceptible may play a role, including the effect on the intrauterine environment for the baby whilst the mother suffers from depression.<ref name="Davis_2018" />
==== Stress ====
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