Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-848d4c4894-75dct Total loading time: 0 Render date: 2024-06-12T08:02:22.090Z Has data issue: false hasContentIssue false

Chapter 5 - Short- and Long-Term Effects of Maternal Obesity and Dysglycaemia for Women and Their Children

from Section II - Exposures Driving Long-Term DOHaD Effects

Published online by Cambridge University Press:  01 December 2022

By
Jodie M. Dodd, ,
Amanda J. Poprzeczny, ,
Andrea R. Deussen  and
Jennie Louise
Edited by
Lucilla Poston ,
Keith M. Godfrey ,
Peter D. Gluckman  and
Mark A. Hanson
Lucilla Poston
Affiliation:
King's College London
Keith M. Godfrey
Affiliation:
University of Southampton
Peter D. Gluckman
Affiliation:
University of Auckland
Mark A. Hanson
Affiliation:
University of Southampton
Get access

Summary

More than half of women of reproductive age are overweight or obese. Such women enter pregnancy at an increased risk of adverse pregnancy, birth and longer-term maternal and child outcomes. Maternal dysglycaemias including impaired glucose tolerance, gestational diabetes and type 2 diabetes confer additional risk for women and their infants. Risks for women include increasing dysglycaemia, pre-eclampsia, caesarean birth and longer-term risks of diabetes and cardiovascular disease; risks for infants include unexplained fetal death, macrosomia and traumatic birth. Longer-term risks for infants include childhood obesity and sequelae. There is growing interest in epigenetic modifications as potential causal mechanisms linking in utero exposures to childhood obesity though findings are inconclusive. Interventions designed to improve diet and physical activity in pregnancy to reduce the risks of obesity and dysglycaemia have been ineffective. Maternal pre-pregnancy BMI is potentially modifiable, and strongly associated with short- and long-term adverse outcomes for women and their infants; lowering pre-pregnancy BMI warrants further investigation through robust randomized trials.

Type
Chapter
Information
Developmental Origins of Health and Disease , pp. 38 - 45
Publisher: Cambridge University Press
Print publication year: 2022

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

World Health Organisation. Obesity and Overweight Fact Sheet. Geneva: 2020 01/04/2020. Report No.Google Scholar
Access Economics. The growing cost of obesity in 2008: three years on. Canberra: Report for Diabetes Australia, 2008.Google Scholar
Wang, Y, Beydoun, MA, Liang, L, Caballero, B, Kumanyika, SK. Will all Americans become overweight or obese? Estimating the progression and cost of the US obesity epidemic. Obesity. 2008;16(10):2323–30.Google Scholar
Australian Institute of Health and Welfare. Australia’s mothers and babies 2017 – in brief. Canberra: Australian Institute of Health, 2019 Contract No.: Cat. no. PER 100.Google Scholar
Chen, C, Xu, X, Yan, Y. Estimated global overweight and obesity burden in pregnant women based on panel data model. PLoS One. 2018;13(8):e0202183. Epub 2018/08/10. doi: 10.1371/journal.pone.0202183. PubMed PMID: 30092099; PubMed Central PMCID: PMCPMC6084991.CrossRefGoogle Scholar
Dodd, JM, Grivell, RM, Nguyen, A-M, Chan, A, Robinson, JS. Maternal and perinatal health outcomes by body mass index category. ANZJOG. 2011;51(2):136–40.Google Scholar
La Coursiere, DY, Bloebaum, L, Duncan, JD, Varner, MW. Population-based trends and correlates of maternal overweight and obesity, Utah 1991–2001. Am J Obstet Gynecol. 2005;192(3);32–9.Google Scholar
Galtier-Dereure, F, Boegner, C, Bringer, J. Obesity and pregnancy: complications and cost. Am J Clin Nutr. 2000;71(5 Suppl):S1242–S8.Google Scholar
Liu, P, Xu, L, Wang, Y, Zhang, Y, Du, Y, Sun, Y, et al. Association between perinatal outcomes and maternal pre-pregnancy body mass index. Obes Rev. 2016;17(11):1091–102. Epub 2016/08/19. doi: 10.1111/obr.12455. PubMed PMID: 27536879.Google Scholar
Poston, L, Caleyachetty, R, Cnattingius, S, Corvalan, C, Uauy, R, Herring, S, et al. Preconceptional and maternal obesity: epidemiology and health consequences. Lancet Diabetes Endocrinol. 2016;4(12):1025–36. Epub 2016/10/17. doi: 10.1016/S2213–8587(16)30217–0. PubMed PMID: 27743975.Google Scholar
Golab, P, Santos, S, Voerman, E, Lawlor, DA, Jaddoe, VWV, Gaillard, R, et al. Influence of maternal obesity on the association between common pregnancy complications and risk of childhood obesity: an individual participant data meta-analysis. Lancet Child Adolesc Health. 2018;2(11):812–21. Epub 2018/09/12. doi: 10.1016/S2352-4642(18)30273-6. PubMed PMID: 30201470; PubMed Central PMCID: PMCPMC6196075.Google Scholar
Kitsantas, P, Gaffney, KF. Risk profiles for overweight/obesity among preschoolers. Early Hum Dev. 2010;86(86):563–8.Google Scholar
Rooney, BL, Mathiason, MA, Schauberger, CW. Predictors of obesity in childhood, adolescence, and adulthood in a birth cohort. Maternal Child Health J. 2011;DOI10.1007/s10995-010-0689-1.Google Scholar
Dodd, JM, Catcheside, B, Scheil, W. Can shoulder dystocia be reliably predicted? Aust N Z J Obstet Gynaecol. 2012;52(3):248–52.Google Scholar
Silverman, BL, Rizzo, TA, Cho, NH, Metzger, BE. Long-term effects of the intrauterine environment. Diabetes Care. 1998;21:B142–9.Google Scholar
Dodd, JM, Crowther, CA, Antoniou, G, Baghurst, P, Robinson, JS. Screening for gestational diabetes: the effect of varying blood glucose definitions in the prediction of adverse maternal and infant health outcomes. Aust N Z J Obstet Gynaecol. 2007;47(4):307–12.Google Scholar
Catalano, PM, McIntyre, HD, Cruickshank, JK, McCance, DR, Dyer, AR, Metzger, BE, et al. The hyperglycemia and adverse pregnancy outcome study: associations of GDM and obesity with pregnancy outcomes. Diabetes Care. 2012;35(4):780–6.Google Scholar
Nelson, SM, Matthews, P, Poston, L. Maternal metabolism and obesity: modifiable determinants of pregnancy outcome. Hum Reprod Update. 2010;16(3):255–75.Google Scholar
Challier, JC, Basu, S, Bintein, T, Minium, J, Hotmire, K, Catalano, PM, et al. Obesity in pregnancy stimulates macrophage accumulation and inflammation in the placenta. Placenta. 2008;29(3):274–81.Google Scholar
Ramsay, JE, Ferrell, WR, Crawford, L, Wallace, AM, Greer, IA, Sattar, N. Maternal obesity is associated with dysregulation of metabolic, vascular, and inflammatory pathways. J Clin Endocrinol Metab. 2002;87(9):4231–7.Google Scholar
Catalano, PM, Hauguel-De, Mouzon, S. Is it time to revisit the Pedersen hypothesis in the face of the obesity epidemic? Am J Obstet Gynecol. 2011;204(6):479–87.Google Scholar
Ingvorsen, C, Brix, S, Ozanne, SE, Hellgren, LI. The effect of maternal Inflammation on foetal programming of metabolic disease. Acta Physiol (Oxf). 2015;214(4):440–9. Epub 2015/05/27. doi: 10.1111/apha.12533. PubMed PMID: 26011013.Google Scholar
Pederson, J. Weight and length at birth of infants of diabetic mothers. Acta Endocrinologica. 1954;16 (4)330–42.Google Scholar
Sattar, N, Wannamethee, SG, Forouhi, NG. Novel biochemical risk factors for type 2 diabetes: pathogenic insights or prediction possibilities? Diabetologia. 2008;51(6):926–40.Google Scholar
McLaughlin, T, Abbasi, F, Lamendola, C, al e. Differentiation between obesity and insulin resistance in the association with C-reactive protein. Circulation. 2002;106(23): 2908–12.Google Scholar
Sibai, B, Dekker, G, Kupferminc, M. Pre-eclampsia. Lancet. 2005;365(9461):785–99.Google Scholar
Rodie, VA, Freeman, DJ, Sattar, N, Greer, IA. Pre-eclampsia and cardiovascular disease: metabolic syndrome of pregnancy? Atherosclerosis. 2004;175(2):189–202.Google Scholar
Grivell, RM, Yelland, LN, Deussen, A, Crowther, CA, Dodd, JM. Antenatal dietary and lifestyle advice for women who are overweight or obese and the effect on fetal growth and adiposity: the LIMIT randomised trial. BJOG. 2016;123(2):233–43.Google Scholar
Poprzeczny, AJ, Louise, J, Deussen, AR, Dodd, JM. The mediating effects of gestational diabetes on fetal growth and adiposity in women who are overweight and obese: secondary analysis of the LIMIT randomised trial. BJOG. 2018;125(12):1558–66.Google Scholar
Schaefer-Graf, UM, Heuer, R, Kilavuz, O, Pandura, A, Henrich, W, Vetter, K. Maternal obesity not maternal glucose values correlates best with high rates of fetal macrosomia in pregnancies complicated by gestational diabetes. J Perinat Med. 2002;30(4):313–21. Epub 2002/09/19. doi: 10.1515/jpm.2002.046. PubMed PMID: 12235720.Google Scholar
Donahue, SM, Rifas-Shiman, SL, Gold, DR, Jouni, ZE, Gillman, MW, Oken, E. Prenatal fatty acid status and child adiposity at age 3 y: results from a US pregnancy cohort. Am J Clin Nutr. 2011;93(4):780–8.Google Scholar
Moon, RJ, Harvey, NC, Robinson, SM, Ntani, G, Davies, JH, Inskip, HM, et al. Maternal plasma polyunsaturated fatty acid status in late pregnancy is associated with offspring body composition in childhood. J Clin Endocrinol Metab. 2013;98(1):299–307.Google Scholar
Gaillard, R, Steegers, EA, Franco, OH, Hofman, A, Jaddoe, VW. Maternal weight gain in different periods of pregnancy and childhood cardio-metabolic outcomes. The Generation R Study. Int J Obes (Lond). 2015;39(4):677–85.Google Scholar
Gaillard, R, Welten, M, Oddy, WH, Beilin, LJ, Mori, TA, Jaddoe, VWV, et al. Associations of maternal prepregnancy body mass index and gestational weight gain with cardio-metabolic risk factors in adolescent offspring: a prospective cohort study. BJOG. 2016;123(2):207–16.Google Scholar
Beillin, L, Huang, RC. Childhood obesity, hypertension, the metabolic syndrome and adult cardiovascular disease. Clin Exp Pharmacol Physiol. 2008;35(4):409–11.Google Scholar
James, WP. The epidemiology of obesity: the size of the problem. J Intern Med. 2008;263(4):336–52.Google Scholar
Thornburg, KL. The programming of cardiovascular disease. J Dev Orig Health Dis. 2015;6(5): 366–76Google Scholar
Simmons, R. Perinatal programming of obesity. Semin Perinatol. 2008;32 (5): 371–4.Google Scholar
Nivoit, P, Morens, C, Van Assche, FA, Jansen, E, Poston, L, Remacle, C, et al. Established diet-induced obesity in female rats leads to offspring hyperphagia, adiposity and insulin resistance. Diabetologia. 2009;52(6):1133–42.Google Scholar
Nathanielsz, PW, Ford, SP, Long, NM, Vega, CC, Reyes-Castro, LA, Zambrano, E. Interventions to prevent adverse fetal programming due to maternal obesity during pregnancy. Nutr Rev. 2013;71 Suppl 1:S78–87.Google Scholar
Poston, L. Maternal obesity, gestational weight gain and diet as determinants of offspring long term health. Best Pract Res Clin Endocrinol Metab. 2012 26(5):627–39.Google Scholar
Gluckman, PD, Hanson, MA, Beedle, AS. Non-genomic transgenerational inheritance of disease risk. Bioessays. 2007;29(2):145–54. Epub 2007/01/18. doi: 10.1002/bies.20522. PubMed PMID: 17226802.Google Scholar
Sharp, GC, for the PACE Consortium. Maternal BMI at the start of pregnancy and offspring epigenome-wide DNA methylation: findings from the pregnancy and childhood epigenetics consortium. Hum Mol Genet. 2017;26(20):4067–85.Google Scholar
Martin, CL, Jima, D, Sharp, GC, McCullough, LE, Park, SS, Gowdy, KM, et al. Maternal pre-pregnancy obesity, offspring cord blood DNA methylation, and offspring cardiometabolic health in early childhood: an epigenome-wide association study. Epigenetics. 2019;14(4):325–40.Google Scholar
Antoun, E, Kitaba, NT, Titcombe, P, Dalrymple, KV, Garratt, ES, Barton, SJ, et al. Maternal dysglycaemia, changes in the infant’s epigenome modified with a diet and physical activity intervention in pregnancy: Secondary analysis of a randomised control trial. PLoS Med. 2020;17(11):e1003229. Epub 2020/11/06. doi: 10.1371/journal.pmed.1003229. PubMed PMID: 33151971; PubMed Central PMCID: PMCPMC7643947Google Scholar
The International Weight Management in Pregnancy (i-WIP) Collaborative Group. Effect of diet and physical activity based interventions in pregnancy on gestational weight gain and pregnancy outcomes: meta-analysis of individual participant data from randomised trials. BMJ. 2017;358:j3119 http://dx.doi.org/10.1136/bmj.j3119.Google Scholar
Dodd, JM, Grivell, RM, Deussen, AR, Hague, W. Metformin for women who are overweight or obese during pregnancy for improving maternal and infant outcomes. Cochrane Database Syst Rev. 2018;7(7):CD010564Google Scholar
Dodd, JM, Louise, J, Deussen, AR, Grivell, RM, Dekker, G, McPhee, AJ, et al. Effect of metformin in addition to dietary and lifestyle advice for pregnant women who are overweight or obese: the GRoW randomised, double-blind placebo-controlled trial. Lancet Diabetes Endocrinol. 2019;7(1):15–24.Google Scholar
Dodd, JM, Cramp, CS, Sui, Z, Yelland, LN, Deussen, AR, Grivell, RM, et al. Effects of antenatal lifestyle advice for women who are overweight or obese on maternal diet and physical activity: the LIMIT randomised trial. BMC Med. 2014;12:161; www.biomedcentral.com/1741-7015/12/161.Google Scholar
Dodd, JM, Turnbull, DA, McPhee, AJ, Deussen, AR, Grivell, RM, Yelland, LN, et al. Antenatal lifestyle advice for women who are overweight or obese: the LIMIT randomised trial. BMJ. 2014;348:g1285.Google Scholar
Dodd, JM, McPhee, AJ, Turnbull, DA, Yelland, LN, Deussen, AR, Grivell, RM, et al. The effect of antenatal lifestyle advice for women who are overweight or obese on neonatal health: the LIMIT randomised trial. BMC Med. 2014;12:163; www.biomedcentral.com/1741-7015/12/163.Google Scholar
Dodd, JM, McPhee, AJ, Deussen, AR, Louise, J, Yelland, LN, Owens, JA, et al. Effects of an antenatal dietary intervention in overweight and obese women on 6 month infant outcomes: follow-up from the LIMIT randomised trial. Int J Obes (Lond). 2018;42(7):1326–1335.Google Scholar
Dodd, JM, Louise, J, Deussen, A. R., McPhee, AJ, Deussen, AR, Owens, JA, et al. Prenatal diet and child growth at 18 months. Pediatrics 2018 Sep;142(3). pii: e20180035. doi: 10.1542/peds.2018-0035. Epub 2018 Aug 8.Google Scholar
Dodd, JM, Deussen, AR, Louise, J. Effects of an antenatal dietary intervention in women with obesity or overweight on child outcomes at 3–5 years of age: LIMIT randomised trial follow-up. Int J Obes (Lond). 2020;44(7) 1531–35. doi: 10.1038/s41366-020-0560-4.Google Scholar
Vinter, CA, Jensen, DM, Ovesen, P, Beck-Nielsen, H, Tanvig, M, Lamont, RF, et al. Postpartum weight retention and breastfeeding among obese women from the randomized controlled Lifestyle in Pregnancy (LiP) trial. Acta Obstet Gynecol Scand. 2014;93(8):794–801.Google Scholar
Horan, MK, McGowan, CA, Gibney, ER, Byrne, J, Donnelly, JM, McAuliffe, FM. Maternal Nutrition and Glycaemic Index during Pregnancy Impacts on Offspring Adiposity at 6 Months of Age--Analysis from the ROLO Randomised Controlled Trial. Nutrients. 2016;Jan 4;8(1). pii: E7. doi: 10.3390/nu8010007.Google Scholar
Patel, N, Godfrey, KM, Pasupathy, D, Levin, J, Flynn, AC, Hayes, L, et al. Infant adiposity following a randomised controlled trial of a behavioural intervention in obese pregnancy. Int J Obes (Lond). 2017;41(7);1018–26. doi: 10.1038/ijo.2017.44.Google Scholar
Tanvig, M, Vinter, CA, Jørgensen, JS, Wehberg, S, Ovesen, PG, Beck-Nielsen, H, et al. Effects of lifestyle intervention in pregnancy and anthropometrics at birth on offspring metabolic profile at 2.8 years: results from the Lifestyle in Pregnancy and Offspring (LiPO) study. J Clin Endocrinol Metab. 2015;100(1):175–83.Google Scholar
Tanvig, M, Vinter, CA, Jørgensen, JS, Wehberg, S, Ovesen, PG, Lamont, RF, et al. Anthropometrics and body composition by dual energy X-ray in children of obese women: a follow-up of a randomized controlled trial (the Lifestyle in Pregnancy and Offspring [LiPO] study). PLoS One. 2014;Feb 24;9(2):e89590.Google Scholar
Geraghty, AA, Alberdi, G, O’Sullivan, EJ, O’Brien, EC, Crosbie, B, Twomey, PJ, et al. Maternal Blood Lipid Profile during Pregnancy and Associations with Child Adiposity: Findings from the ROLO Study. PLoS One. 2016;11(8):e0161206.Google Scholar
Horan, MK, Donnelly, JM, McGowan, CA, Gibney, ER, McAuliffe, FM. The association between maternal nutrition and lifestyle during pregnancy and 2-year-old offspring adiposity: analysis from the ROLO study. Z Gesundh Wiss. 2016;24(5):427–36.Google Scholar
Scully, H, Alberdi, G, Segurado, R, McNamara, A, Lindsay, K, Horan, M, et al. Child Care Exposure Influences Childhood Adiposity at 2 Years: Analysis from the ROLO Study. Child Obes. 2017;13(2):93–101.Google Scholar
Louise, J, Poprzeczny, AJ, Deussen, AR, Vinter, C, Tanvig, M, Jensen, DM, et al. The effects of dietary and lifestyle interventions among pregnant women with overweight or obesity on early childhood outcomes: an individual participant data meta-analysis from randomised trials. BMC Med. 2021;19(1):128. Epub 2021/06/03. doi: 10.1186/s12916-021-01995-6. PubMed PMID: 34074261; PubMed Central PMCID: PMCPMC8170974.Google Scholar
Institute of Medicine. Weight gain during pregnancy: reexamining the guidelines. Washington D.C.:2009.Google Scholar
Hanson, MA, Barker, M, Bustreo, F, Dodd, JM, Kumanyika, S, Norris, S, et al. Interventions to prevent preconception and maternal obesity. Lancet Diabetes Endocrinol 2017;5(1):65–76.Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×