Influence of Maternal Obesity on the Long-Term Health of Offspring

Abstract

Maternal obesity is a growing public health problem across the world. In many high-income countries, more than 1 in 5 pregnant women are now categorised as obese. Compared to offspring born to normal weight women, babies born to obese mothers have a greater risk of adverse health outcomes across their lifespan, including obesity, cardiovascular disease and premature mortality in adulthood. The mechanisms through which maternal obesity elicits this long-term influence on offspring health is believed to represent a `programming' effect of the obesogenic in utero environment. Alterations in maternal glucose and insulin sensitivity and hypothalamic-pituitary-adrenal axis regulation have been described in association with maternal obesity and may contribute to fetal programming. In addition, epigenetic modifications in maternal adipose and feto-placental tissues have been described, although their clinical significance remains uncertain. Lifestyle and medical interventions have shown limited success in attenuating the impact of maternal obesity on offspring growth and body composition during infancy, although longer-term follow-up is required.