The Uterine Environment and Childhood Obesity Risk: Mechanisms and Predictions

Abstract

Purpose of Review Childhood obesity is a growing health problem in many populations, hence the urgent need to unravel the underlying mechanisms. Some evidence suggests that exposure to suboptimal intrauterine environments can program foetal metabolic health, with adverse consequences in later life, including susceptibility to childhood obesity. Findings Factors such as high and low foetal birth weight, excessive gestational-weight-gain, maternal stress and smoking are all associated with increased risk of childhood obesity in observational studies. Animal models, where both genetic background and the postnatal environment can be carefully controlled, suggest that several different mechanisms, including epigenetic changes, dysregulation of adipose tissue development and programming of appetite, may be key drivers of developmental programming of childhood obesity. However, the influence of genetics and the post-natal environment are much more difficult to disentangle as independent effects in human studies, which are also complicated by low follow-up rates. Summary Suboptimal intrauterine environments interact with maternal and foetal genetics and with the postnatal environment to contribute to the risk of childhood obesity. Maternal metabolic challenges, for example obesity and insulin resistance, contribute to the risk of foetal overgrowth and subsequent adiposity in childhood. To protect the long-term health of populations, research focusing on effective means of identifying and intervening in the transgenerational cycle of childhood obesity is required.

Exploring Maternal Diet-Epigenetic-Gut Microbiome Crosstalk as an Intervention Strategy to Counter Early Obesity Programming

“…The most important factors that predispose to the development of obesity in childhood are represented by maternal obesity, gestational weight gain (GWG), maternal high-fat (HF) feeding, maternal hyperglycemia, gestational diabetes mellitus (GDM), maternal smoking and stress, low birth weight with rapid postnatal catch-up growth, and high birth weight [6]. Maternal obesity, defined by the body mass index (BMI) either before conception or during pregnancy, and GWG are frequently associated with childhood obesity [7,8].…”

Value of foetal umbilical vein standardised blood flow volume in predicting weight gain in the third trimester: a prospective case-cohort study

“…Macrosomic pregnancies may result in obstructed labour, such as prolonged labour or postpartum haemorrhage ( 2 , 3 ). Additionally, research suggests that intrauterine overgrowth may be linked to long-term adverse outcomes in children, including an increased risk of hypertension and type 2 diabetes ( 4 , 5 ).…”