The IX t h Makassed Medical Congress - American University of Beirut

T h e I X t h M a k a s e d M e d i c a l C o n g r e s s
LONG-TERM IMPACT OF PERINATAL ENVIROMENT
Laurent Storme MD
The main causes of morbidity and mortality have perinatal environmental origins. Early intrauterine
and postnatal development is a unique period of vulnerability during which adverse
environmental stressors, disruptors and insults, may have lifelong impact on health. Perinatal
programming may permanently modify disease susceptibility. We now know that such insults,
even transient, program lifelong alterations in homeostatic regulations which lead to the
commonest diseases encountered in adulthood, including diabetes, hypertension, infarcts,
stroke, and cancer.
The current hypothesis proposes that fetal adaptations to intrauterine and maternal conditions
during development is able to impair structure and function of organs. Perinatal programming
may cause permanent changes in vital organs, altered cell number, imbalance in distribution of
different cell types, and altered blood supply or receptor numbers.
The mechanisms underlying the early programming of diseases later in life is presently uncertain.
However, experimental data and clinical studies suggest that epigenetic changes in regulatory
genes and growth-related genes play a significant role in the perinatal programming.
Improvements in our understanding of the mechanisms would trigger the development of
preventive and therapeutic strategies. There is an urgent need for a better understanding of
what might well be a threat to the sustainable development of human individuals.
PERINATAL HEALTH IN MIDDLE EAST AND NORTH AFRICA AREA
Robert Sacy MD, R. Kamel, I. Dabaj
We will study main issues of perinatal health in MENA area which includes countries of Middle
East and North Africa. Governments in region are trying their best to achieve equity among
citizens and to respect human rights keeping the cultural values at primary importance. “Good
Health is a basic human right” [12] and a must for a socioeconomic development. Women play
a major role in raising children and family, thus, she has important role in society. In MENA area,
despite all accomplishments in past years, there were lots of reproductive issues and major
threats on women’s health which lead to threats on children’s health. There is a link between 3
important issues: health, social development and size of gaps between genders and different
socioeconomic status. War was one of the major factors affecting all the 3 issues..
Maternal and neonatal death; war; consanguinity, early marriage; sexually transmitted diseases;
violence will be reviewed. Data were collected from review studies. A large part of our information
was taken from W.H.O, Ministry of Health in different Arabic countries and many reports from
United Nations, USAID, UNDP, and UNICEF.
Mortality
Maternal mortality: Health of newborn is linked to safety of mother. Children before age 10 whom
mothers died are 3 to 10 times more likely to die 2 years earlier than children with living parents.
Maternal mortality in MENA region remains high with 18000 deaths. Mortality in Yemen is one of
the highest in the world [10]. After Gulf war, mortality in Iraq increased rapidly. [11] Major causes of
death are bleeding, infections and eclampsia [23]. (Fig.1)
Neonatal death and still birth: low birth weight is a debatable cause of death [13]. Stillbirths account
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