Maternal obesity in females born small: Pregnancy complications and offspring disease risk

Abstract

Obesity is a major public health crisis, with 1.6 billion adults worldwide being classified as overweight or obese in 2014. Therefore, it is not surprising that the number of women who are overweight or obese at the time of conception is increasing. Obesity during pregnancy is associated with the development of gestational diabetes and preeclampsia. The developmental origins of health and disease hypothesis proposes that perturbations during critical stages of development can result in adverse fetal changes that leads to an increased risk of developing diseases in adulthood. Of particular concern, children born to obese mothers are at a greater risk of developing cardiometabolic disease. One subset of the population who are predisposed to developing obesity are children born small for gestational age, which occurs in 10% of pregnancies worldwide. Epidemiological studies report that these growth-restricted children have an increased susceptibility to type 2 diabetes, obesity, and hypertension. Importantly during pregnancy, growth-restricted females have a higher risk of developing cardiometabolic disease, indicating that they may have an exacerbated phenotype if they are also overweight or obese. Thus, the development of early pregnancy interventions targeted to obese mothers may prevent their children from developing cardiometabolic disease in adulthood.

<p>The Body Composition in Early Pregnancy is Associated with the Risk of Development of Gestational Diabetes Mellitus Late During the Second Trimester</p>

“…4,5 Pregnant women with GDM have a significantly higher risk of giving birth to high or low birth weight babies, 6,7 who are another potential cause of diabetes. 8,9 Normal-weight infants born to GDM mothers had a higher incidence of obesity and impaired glucose tolerance during puberty than normal-weight infants born to mothers with normal blood glucose. 10 This shows that GDM can be an important cause of the increased prevalence of type 2 diabetes, and early detection and intervention of GDM pregnant women are crucial ways to reduce the incidence of type 2 diabetes.…”

The effect of exercise on maternal complications and birth outcomes in overweight or obese pregnant women: a meta-analysis

“…Pregnancy-induced hypertension is one of the most common pregnancy complications, which causes serious damage to the heart, brain, kidney, liver, and other important organs in pregnant women, and poses a significant threat to mothers and infants (14)(15)(16). The increased blood glucose of overweight or obese pregnant women leads to an increase in fetal blood glucose and an increase in insulin secretion by fetal islet β cells stimulated by fetal hyperglycemia (17)(18)(19)(20). Fetal insulin mainly promotes fetal growth and promotes weight gain, which may lead to macrosomia.…”

Exercise improves metabolic function and alters the microbiome in rats with gestational diabetes

“…Children born small are predisposed to developing obesity and comprise approximately 10% of pregnancies worldwide. 4 The most significant risk factor for developing GDM is being overweight/obese 5,6 ; hence, there is a fourfold to ninefold increase in GDM frequency in obese women. 2 This mimics the characteristics of human gestational diabetes mellitus (GDM), which complicates over 25% of pregnancies 3 and has major short-and long-term health effects for the mother and child.…”