Complications at Birth May Accelerate Aging

An elderly person's hand reaches out to a child's hand

The stress of being the U.S. President can take a toll. Hair grays. Wrinkles deepen. By the time a four or eight-year term is complete, presidents often look significantly older than might be expected. In this case, the stress of running the United States has accelerated the perceived aging process. Similarly, for babies, complications before and shortly after birth can also speed up aging processes—and these effects, during a critical developmental period, can last a lifetime.

Research published in the November 2014 issue of Pediatrics by Idan Shalev, Assistant Professor of Biobehavioral Health and faculty member of the Child Maltreatment Solutions Network, links the stress of perinatal complications to advanced aging by midlife. The research derives from the “Barker Hypothesis,” a theory proposed by Physician David Barker that links complications at birth to morbidity and early mortality. Dr. Shalev’s research with Drs. Avshalom Caspi and Terrie Moffitt from Duke University, part of an international team from the United States, United Kingdom, and New Zealand, reveals that linkages extend to accelerated aging not just outside but inside the body.

Following 1,037 individuals from birth to age 38 years of age, the research team aimed to identify the mechanisms behind accelerated aging. Nearly 26 percent of the study participants experienced one perinatal complication, and 11 percent experienced two or more. Examples of complications are low birth weight, small size at birth, and hypertension and diabetes in the mother during pregnancy. The study participants were from the Dunedin Multidisciplinary Health and Development Study, a longitudinal investigation of health and behavior in a complete cohort of individuals, starting from birth.

“An early stressful environment changes the body’s structure, physiology and metabolism in ways that have long-lasting effects,” Dr. Shalev said. “I was interested in identifying the mechanisms at the molecular level that help to explain this process; to find out what is going on between the time someone is born and the diseases they experience 40 years later.”

Dr. Shalev said that, during the gestation period, babies prepare themselves for the world they are about to enter, and the prenatal period is a critical time for the development of the biological systems. For example, in Dr. Barker’s early studies, babies who had malnourished mothers—in this case, Dutch women pregnant and living in famine conditions during World War II—were born significantly smaller and below a healthy birth-weight. The babies had biologically adapted to a world where food was scarce, and this early adaptation had long lasting effects on aging processes. For example, babies suffering from low-birth weight often exhibited chronic diseases later in life, like diabetes, high blood pressure, and heart disease.

Cellular Effects

Perinatal complications (those occurring shortly before or after birth) have a serious effect on our DNA, specifically telomeres, which are located at the tips of chromosomes and protect chromosomes from deterioration. Over time, telomeres naturally deteriorate or shorten as a person ages. When a birth has complications, telomere-health declines early, and the individual essentially gets a head start on the aging process.

“From the start, cells are older than they should be in people who experience birth complications,” Dr. Shalev said. “This early-life programming sets the stage for the child’s life and the apparent ‘age’ of his or her cells.”

Through blood sampling, the research team found that study participants who had experienced perinatal complications had shorter telomeres than those who had not. They also found that individuals who experienced two or more complications had the shortest telomeres.

“This is important,” Dr. Shalev said. “We know short telomeres link to biological complications, which link to health problems later in life. If you are a clinician and learn that your patient had complications at birth, you can suggest interventions that help maintain telomere length and slow aging. Examples of interventions are a healthier diet, an exercise routine, and meditation.”

Facial Aging

The effects of perinatal complications do not end at cellular aging. Dr. Shalev and his colleagues found that they have an effect outside the body as well--on facial aging. The researchers recruited a panel of undergraduate students and showed them photographs of the study participants at age 38. Using two scales, the student raters were asked if the individuals in the pictures were “young looking” or “old looking.”

The study participants who had complications during birth were rated as looking older.. Participants who experienced two or more complications looked older than those with one, and even older than those without any complications at birth.

“It’s like what happens to U.S. presidents in a very short amount of time,” Dr. Shalev said. “These individuals actually appear to be older than their chronological age because of what stress did to their cells when their cells were developing.”

Of course, an individual’s stressful experiences are not limited to the perinatal period. The researchers considered other factors that could affect facial aging (such as sun exposure and smoking) and cellular aging (such as physical and mental health). They found that these variables had effects, however the participants with perinatal complications still had shorter telomeres, on average, than those who did not, regardless of stresses they faced later in life.

Intervention Opportunities and Future Steps

Bringing an end to perinatal complications may not be possible in the near future, but as their connection to early aging becomes clearer, scientists may be able to develop treatments to limit or reverse accelerated aging effects that start very early in life.

Dr. Shalev said there are ways to maintain and perhaps even lengthen telomeres. Activities like healthy eating, exercise, and mediation, for example, have been found to slow telomere erosion.