Relationship of prenatal maternal obesity and diabetes to offspring neurodevelopmental and psychiatric disorders: a narrative review

Abstract

Obesity and diabetes is a worldwide public health problem among women of reproductive age. This narrative review highlights recent epidemiological studies regarding associations of maternal obesity and diabetes with neurodevelopmental and psychiatric disorders in offspring, and provides an overview of plausible underlying mechanisms and challenges for future human studies. A comprehensive search strategy selected terms that corresponded to the domains of interest (maternal obesity, different types of diabetes, offspring cognitive functions and neuropsychiatric disorders). The databases searched for articles published between January 2010 and April 2019 were PubMed, Web of Science and CINAHL. Evidence from epidemiological studies strongly suggests that maternal pre-pregnancy obesity is associated with increased risks for autism spectrum disorder, attention-deficit hyperactivity disorder and cognitive dysfunction with modest effect sizes, and that maternal diabetes is associated with the risk of the former two disorders. The influence of maternal obesity on other psychiatric disorders is less well studied, but there are reports of associations with increased risks for offspring depression, anxiety, schizophrenia and eating disorders, at modest effect sizes. It remains unclear whether these associations are due to intrauterine mechanisms or explained by confounding family-based sociodemographic, lifestyle and genetic factors. The plausible underlying mechanisms have been explored primarily in animal models, and are yet to be further investigated in human studies.

High Maternal Omega-3 Supplementation Dysregulates Body Weight and Leptin in Newborn Male and Female Rats: Implications for Hypothalamic Developmental Programming

“…The detrimental effects of poor maternal diet and maternal diet-induced obesity on offspring development are well established [ 46 , 47 , 48 ], as is the role that maternal diet plays in disrupting the maturation of hypothalamic satiety signalling [ 13 ]. The poor neurodevelopmental consequences of maternal obesity have been attributed in part to insufficient intake of ω3 fatty acids [ 23 ].…”

Mechanisms Underlying the Cognitive and Behavioural Effects of Maternal Obesity

“…While maternal obesity has long been known to pose increased cardiometabolic risk for offspring, reviews and meta-analyses over the past decade have focused on the impacts of maternal obesity on offspring behaviour and cognition [ 5 , 50 ]. For instance, in a study of 1361 mother-child pairs (Project Viva cohort), Monthe-Dreze et al [ 20 ] found that higher pre-pregnancy BMI (>30) was associated with poorer visual motor abilities at three years of age, with this relationship partly mediated by maternal inflammation (dietary inflammatory index and n−6:n−3 PUFA ratio).…”

“…The potential link between maternal obesity and Autism Spectrum Disorder (ASD) has been extensively investigated over the past decade or so. Several recent meta-analyses and reviews indicate an increased risk of ASD in children of mothers who were overweight or obese at the time of conception [ 6 , 50 ]. In addition, several studies have examined the impact of maternal obesity on psychosocial development, regulatory behaviour, internalising and externalising behaviour.…”

Understanding the Link Between Maternal Overnutrition, Cardio-Metabolic Dysfunction and Cognitive Aging

“…More specifically, maternal obesity was linked to reduction in child intelligence quotient (IQ) scores (Neggers et al, 2003;Gage et al, 2013;Bliddal et al, 2014;Pugh et al, 2015), cognitive test scores (Tanda et al, 2013), impaired neuropsychological development (Hinkle et al, 2012;Casas et al, 2013;Huang et al, 2014) and autism spectrum disorder and other intellectual disabilities (Brion et al, 2011;Li et al, 2016;Kong et al, 2020) in the children. Additionally, other studies suggested that an association might exist between maternal obesity and increased symptoms of attention-deficit hyperactivity disorder (ADHD) in children (Rodriguez et al, 2008;Rodriguez, 2010;Buss et al, 2012;Jenabi et al, 2019;Kong et al, 2020;Robinson et al, 2020). Although the association between maternal obesity and offspring's cognitive disabilities was described, the current literature is still scarce, and findings are inconsistent (Brion et al, 2011;Keim and Pruitt, 2012;Van Lieshout, 2013;Bliddal et al, 2014).…”