Fetal Origin of Osteoarthritis

Traditionally, osteoarthritis has been viewed as an age-related degenerative disease primarily affecting the elderly population. However, recent studies have suggested that osteoarthritis has a fetal origin and is associated with metabolic syndrome. Low birth weight infants who experienced fetal chondrodysplasia during the intrauterine period due to maternal exposure to adverse environmental conditions showed an increased incidence of osteoarthritis in adulthood, which was further exacerbated by external stimulation after birth. The adverse environment during pregnancy may cause programming changes in cartilage matrix metabolism, glycolipid metabolic function, and subchondral bone osteogenesis hypofunction through high intrauterine maternal glucocorticoids, leading to persistent reduction in articular cartilage quality and susceptibility to adult osteoarthritis even over multiple generations. These programming changes involve abnormal epigenetic modifications. Thus, the proposed fetal developmental origin of osteoarthritis and its intrauterine programming mechanism provide a theoretical and experimental basis for the early comprehensive prevention and treatment of fetal-originated osteoarthritis. This highlights the importance of addressing the intrauterine environment to prevent the onset of osteoarthritis in later life.