People often refer to birth as the miracle of life. And while modern science and medicine have developed a significant understanding of the conception, growth, and birth of babies, that should not take away the awe we feel when a new, tiny, unique human enters this world.
One such awe-filled fact involves the explosive cell growth we see from zygote to newborn baby. In just about 40 cell divisions, a human infant grows from a single fertilized egg to approximately one trillion cells! This is doubly amazing when you consider that reaching full adult size requires only 4–5 additional cell doublings.
The math alone tells us that the vast majority of the structural cellular construction every person will ever undergo occurs in utero. It stands to reason, then, that interruptions during this phase have widespread impacts on long-term health. And, according to Chris Magryta, MD, this is indeed the case. The fast-developing fetal brain is hyper-vulnerable to any change in its mother’s insulin resistance, the resulting inflammatory state, and nutrient deficits during pregnancy.
The Connection Between Immunometabolism and Insulin Resistance
Humans have walked the earth for hundreds of thousands of years. During that time, our bodies developed evolutionary advantages, including adaptations involving pregnancy. One such advantage involves mothers’ ability to efficiently metabolize fructose.
If a pre-modern mother was able to eat larger volumes of fruit or starches during pregnancy (when it was available), she was more likely to survive, have adequate breast milk, and have everything she needed to produce that baby. And because most humans throughout history have lived in an environment with scarce resources, this makes sense.
But we no longer live in such an environment. We have the opposite problem—too much easily accessible fructose—and our bodies haven’t caught up. Evolutionarily speaking, we are entirely out of place. (“We are polar bears in the desert,” says Dr. Magryta.) So when a modern-day mother consumes ultra-processed diets packed with refined starch polymers and added fructose, she is much more likely to end up with insulin resistance. This, in turn, drives placental hypoxia, elevated uric acid, and systemic inflammation.
The Link Between Maternal Immune Activation and Autism
Systemic inflammation is never a good thing, and in this case it poses a risk not only to the mother but to the developing child she carries.
For starters, high blood sugar and diets high in refined starches or fructose increase myeloid-derived suppressor cells, which weaken the body's ability to kill off pathogens. Naturally, this increases the risk of infection. And when a mother experiences a severe viral infection (such as the flu or COVID-19) while pregnant, she can also develop maternal immune activation (MIA).
When a mother has MIA, her immune system releases elevated levels of pro-inflammatory signaling proteins, or cytokines. These maternal inflammatory cytokines transmit signals through the placenta into the developing fetus’s circulation. Once these cytokine signals reach the baby’s brain, they over-activate microglia—the primary immune cells of the central nervous system—which alters normal brain-building activities while inducing cellular oxidative stress and mitochondrial strain.
The upshot of inflammation passing from mother to baby, thereby affecting fetal neural development, is a heightened risk for the baby to develop autism, with odds skyrocketing to 1.94:1.
More and more children are developing asthma, eczema, and autism. Why is this happening? In “Pediatric Health from the Womb and Beyond,” Chris Magryta, MD, argues the answer lies in pregnancy and the first few years of life.
Standard medical training teaches you to treat pediatric disease only after symptoms appear. But many of these diseases first gained a foothold in utero due to maternal insulin resistance, nutrient insufficiency, chronic stress, dysbiosis, and toxin exposure, all of which lead to chronic inflammation. That inflammation reaches the fetus through the placenta and shapes the infant's health and development long before symptoms appear.
Dr. Magryta’s Kharrazian Institute master class focuses on the levers that remain modifiable at each stage: preconception, pregnancy, delivery, and the first months of life, including feeding and environmental exposures. You will learn to distinguish asthma endotypes, identify relevant clinical markers, and explore the interventions that reduced disease severity in his own patients.
You don’t have to wait until symptoms appear to start treating pediatric asthma, eczema, and autism; there is a better way. Click here to learn more and register today.
Critical Cofactor Timing
In the growing fetus, enzymes trigger chemical reactions throughout the body. Cofactors—which include essential vitamins like folate, B12, and choline and minerals like iron and zinc—allow those enzymes to work properly. When cofactor levels are too low, these enzymatic pathways slow down, creating what Dr. Magryta calls “antecedent triggers”: hidden root causes that set the stage for later health and neurodevelopmental challenges.
For example, folate, B12, and choline provide methyl donors (carbon atoms with free hydrogens) that act like chemical switches, turning beneficial genes on and silencing harmful genes during fetal development. Shortages of these cofactors during the first trimester can prevent proper closure of the neural tube, which is why doctors often supplement mothers with choline and B12. Choline is also converted into sphingomyelin, a structural fat needed to build the myelin sheath. Getting enough gestational choline is therefore necessary to support infant self-regulation and brain-cell communication.
Likewise, iron is a required cofactor for building neurons, dendrites, and memory centers in the brain, like the hippocampus. If a pregnant mother's iron levels drop, however, her body prioritizes replenishing red blood cells first, leaving her immune enzymes under-fueled. This increases her risk of catching infections, which can trigger MIA (as we discussed above) and disrupt fetal brain development.
“Pediatric Health from the Womb and Beyond” by Chris Magryta, MD
The supercharged growth of the fetus during pregnancy is a biological wonder, but it also poses special challenges for modern mothers. Our environmental reality is vastly different from that of our ancestors, and this has led to new risks we must consider. Overly abundant fructose in ultra-processed food can lead to inflammation, MIA, and increased risk of autism. Insufficient nutrient intake can negatively affect fetal brain development.
Given all this, it should be clear that waiting until birth to address pediatric health misses the critical windows for fetal brain development. In his KI Master Class, “Pediatric Health from the Womb and Beyond,” Dr. Chris Magryta teaches you how to address pediatric health from the earliest stages of pregnancy onward. He provides the tools to help shape neurodevelopmental outcomes, rather than assuming they are fixed from the outset.
The course organizes his findings into a clinical framework you can apply in your practice. It explores maternal insulin resistance, nutrient sufficiency, stress, sleep, toxins, and the microbiome. Dr. Magryta then applies these concepts to two conditions commonly seen in pediatric practice: asthma and atopic dermatitis.
You can change your pediatric patients’ health trajectories. Dr. Magryta can show you how. Click here to register today.
Chris Magryta, MD, is a husband, father, pediatrician, writer, and podcaster who peels back the layers on why our species has become disease-prone. He has practiced medicine at Salisbury Pediatric Associates in Salisbury, North Carolina, for 24 years and sees each child as an incubator of change for human health.
Frequently Asked Questions
How does maternal insulin resistance directly impair fetal neurodevelopment?
High maternal blood sugar and excess fructose consumption trigger systemic inflammation, placental hypoxia, and elevated uric acid. This inflammatory state increases myeloid-derived suppressor cells and raises the risk of severe prenatal infections. When maternal immune activation (MIA) occurs, inflammatory cytokines cross the placenta, over-activating the fetus’s microglial cells and disrupting normal brain construction and mitochondrial function.
Why is cofactor timing so critical during pregnancy?
Key cofactors like folate, B12, choline, iron, and zinc drive essential enzymatic pathways and gene expression during peak cell division. If iron or methyl donors are deficient during early pregnancy, neural tube closure and hippocampal development can be permanently compromised.
What are "antecedent triggers" in pediatric functional medicine?
Antecedent triggers are hidden root-cause factors—such as maternal nutrient deficits, gut dysbiosis, chronic stress, and toxin exposure—that occur in utero or during early infancy. They set the stage for systemic inflammation and immune dysregulation long before clinical symptoms like asthma, eczema, or neurodevelopmental delays present in a pediatric patient.
How will Dr. Chris Magryta’s master class help me implement these preconception and prenatal strategies in my practice?
In "Pediatric Health from the Womb and Beyond," Dr. Magryta delivers an actionable clinical framework that moves beyond reactive symptom management. You will learn how to identify endotypes, interpret early biomarkers, and apply targeted interventions across preconception, pregnancy, delivery, and early infancy to improve outcomes for conditions like pediatric asthma, eczema, and autism. Click here to explore the curriculum and register for the master class today.
