Overweight and obesity in pregnancy: their impact on epigenetics

European Journal of Clinical Nutrition ◽

10.1038/s41430-021-00905-6 ◽

2021 ◽

Author(s):

Christoph Reichetzeder

Keyword(s):

Clinical Studies ◽

Maternal Obesity ◽

Later Life ◽

Overweight And Obesity ◽

Cardiometabolic Disease ◽

Mother And Child ◽

Prevalence Of Obesity ◽

Obesity In Pregnancy ◽

And Function ◽

In Pregnancy

AbstractOver the last few decades, the prevalence of obesity has risen to epidemic proportions worldwide. Consequently, the number of obesity in pregnancy has risen drastically. Gestational overweight and obesity are associated with impaired outcomes for mother and child. Furthermore, studies show that maternal obesity can lead to long-term consequences in the offspring, increasing the risk for obesity and cardiometabolic disease in later life. In addition to genetic mechanisms, mounting evidence demonstrates the induction of epigenetic alterations by maternal obesity, which can affect the offspring’s phenotype, thereby influencing the later risk of obesity and cardiometabolic disease. Clear evidence in this regard comes from various animal models of maternal obesity. Evidence derived from clinical studies remains limited. The current article gives an overview of pathophysiological changes associated with maternal obesity and their consequences on placental structure and function. Furthermore, a short excurse is given on epigenetic mechanisms and emerging data regarding a putative interaction between metabolism and epigenetics. Finally, a summary of important findings of animal and clinical studies investigating maternal obesity-related epigenetic effects is presented also addressing current limitations of clinical studies.

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Impact of maternal obesity on offspring obesity and cardiometabolic disease risk

Reproduction ◽

10.1530/rep-10-0077 ◽

2010 ◽

Vol 140 (3) ◽

pp. 387-398 ◽

Cited By ~ 255

Author(s):

Amanda J Drake ◽

Rebecca M Reynolds

Keyword(s):

Maternal Obesity ◽

Disease Risk ◽

Vascular Dysfunction ◽

Later Life ◽

Adverse Outcomes ◽

Cardiometabolic Health ◽

Mother And Child ◽

Prevalence Of Obesity ◽

And Function

The prevalence of obesity among pregnant women is increasing. In addition to the short-term complications of obesity during pregnancy in both mother and child, it is now recognised that maternal obesity has long-term adverse outcomes for the health of her offspring in later life. Evidence from both animal and human studies indicates that maternal obesity increases the risk for the offspring in developing obesity and altering body composition in child- and adulthood and, additionally, it also has an impact on the offspring's cardiometabolic health with dysregulation of metabolism including glucose/insulin homoeostasis, and development of hypertension and vascular dysfunction. Potential mechanisms include effects on the development and function of adipose tissue, pancreas, muscle, liver, the vasculature and the brain. Further studies are required to elucidate the mechanisms underpinning the programming of disease risk in the offspring as a consequence of maternal obesity. The ultimate aim is to identify potential targets, which may be amenable to prevention or early intervention in order to improve the health of this and future generations.

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Obesity in pregnancy: risks and management

Obstetric Medicine ◽

10.1258/om.2009.090009 ◽

2009 ◽

Vol 2 (2) ◽

pp. 52-62 ◽

Cited By ~ 18

Author(s):

Kate J Fitzsimons ◽

Jo Modder ◽

Ian A Greer

Keyword(s):

Maternal Obesity ◽

Research Priorities ◽

Future Research ◽

Increased Risk ◽

Fetal Complications ◽

Prevalence Of Obesity ◽

Obesity In Pregnancy ◽

The Uk ◽

Pregnancy Weight ◽

In Pregnancy

Maternal obesity is now considered one of the most commonly occurring risk factors seen in obstetric practice. Compared with women with a healthy pre-pregnancy weight, women with obesity are at increased risk of miscarriage, gestational diabetes, preeclampsia, venous thromboembolism, induced labour, caesarean section, anaesthetic complications and wound infections, and they are less likely to initiate or maintain breastfeeding. Babies of obese mothers are at increased risk of stillbirth, congenital anomalies, prematurity, macrosomia and neonatal death. Intrauterine exposure to obesity is also associated with an increased risk of developing obesity and metabolic disorders in childhood. This article reviews the prevalence of obesity in pregnancy and the associated maternal and fetal complications. Recommendations and suggestions for pre-conception, antenatal and postnatal care of women with obesity are presented, and current research in the UK and future research priorities are considered.

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Maternal pre-pregnancy obesity and timing of puberty in sons and daughters: a population-based cohort study

International Journal of Epidemiology ◽

10.1093/ije/dyz125 ◽

2019 ◽

Vol 48 (5) ◽

pp. 1684-1694 ◽

Cited By ~ 4

Author(s):

Nis Brix ◽

Andreas Ernst ◽

Lea L B Lauridsen ◽

Onyebuchi A Arah ◽

Ellen A Nohr ◽

...

Keyword(s):

Body Mass Index ◽

Potential Effect ◽

Population Based ◽

Normal Weight ◽

Overweight And Obesity ◽

Prevalence Of Obesity ◽

Timing Of Puberty ◽

Obesity In Pregnancy ◽

Axillary Hair ◽

In Pregnancy

Abstract Background In many countries, an increased prevalence of obesity in pregnancy has coincided with a declining pubertal age. We aimed to explore the potential effect of maternal pre-pregnancy overweight and obesity on timing of puberty in sons and daughters. Methods Between 2012 and 2018, 15 819 of 22 439 invited children from the Danish National Birth Cohort, born 2000–03, provided half-yearly information from the age of 11 years on the pubertal milestones: Tanner stages, voice break, first ejaculation, menarche, acne and axillary hair. We estimated adjusted mean monthly differences (with 95% confidence intervals) in age at attaining the pubertal milestones for children exposed to maternal pre-pregnancy obesity [body mass index (BMI) ≥30.0 kg/m2] or overweight (BMI 25.0 to 29.9 kg/m2) with normal weight (BMI 18.5 to 24.9 kg/m2) as reference. In mediation analysis, we explored whether childhood BMI at age 7 years mediated the associations. Results Maternal pre-pregnancy obesity was associated with earlier age at attaining most pubertal milestones in sons, and pre-pregnancy overweight and obesity were associated with earlier age at attaining all pubertal milestones in daughters. When combining all pubertal milestones, pre-pregnancy obesity [sons: −1.5 (−2.5, −0.4) months; daughters: −3.2 (−4.2, −2.1) months] and overweight [daughters only: −2.6 (−3.3, −1.8) months] were associated with earlier timing of puberty. The associations in sons were completely mediated by higher childhood BMI and partly so in daughters. Conclusions Maternal pre-pregnancy obesity appears to lower timing of puberty through childhood obesity in sons and mainly through other mechanisms in daughters.

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Maternal Obesity, Inflammation, and Developmental Programming

BioMed Research International ◽

10.1155/2014/418975 ◽

2014 ◽

Vol 2014 ◽

pp. 1-14 ◽

Cited By ~ 96

Author(s):

Stephanie A. Segovia ◽

Mark H. Vickers ◽

Clint Gray ◽

Clare M. Reynolds

Keyword(s):

Maternal Obesity ◽

Later Life ◽

Developmental Programming ◽

Health Concern ◽

Low Grade ◽

Critical Periods ◽

Omega 3 ◽

Child Bearing ◽

Prevalence Of Obesity ◽

Low Grade Inflammation

The prevalence of obesity, especially in women of child-bearing age, is a global health concern. In addition to increasing the immediate risk of gestational complications, there is accumulating evidence that maternal obesity also has long-term consequences for the offspring. The concept of developmental programming describes the process in which an environmental stimulus, including altered nutrition, during critical periods of development can program alterations in organogenesis, tissue development, and metabolism, predisposing offspring to obesity and metabolic and cardiovascular disorders in later life. Although the mechanisms underpinning programming of metabolic disorders remain poorly defined, it has become increasingly clear that low-grade inflammation is associated with obesity and its comorbidities. This review will discuss maternal metainflammation as a mediator of programming in insulin sensitive tissues in offspring. Use of nutritional anti-inflammatories in pregnancy including omega 3 fatty acids, resveratrol, curcumin, and taurine may provide beneficial intervention strategies to ameliorate maternal obesity-induced programming.

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Ischaemic heart disease and pregnancy

Heart ◽

10.1136/heartjnl-2018-313454 ◽

2018 ◽

Vol 105 (3) ◽

pp. 189-195 ◽

Cited By ~ 9

Author(s):

Matthew Cauldwell ◽

Lucia Baris ◽

Jolien W Roos-Hesselink ◽

Mark R Johnson

Keyword(s):

Heart Disease ◽

Ischaemic Heart Disease ◽

Maternal Morbidity ◽

Inflammatory Diseases ◽

Later Life ◽

Shock Delivery ◽

Chronic Inflammatory Diseases ◽

Prevalence Of Obesity ◽

History Of ◽

In Pregnancy

Although ischaemic heart disease is currently rarely encountered in pregnancy, occurring between 2.8 and 6.2 per 100 000 deliveries, it is becoming more common as women delay becoming pregnant until later life, when medical comorbidities are more common, and because of the higher prevalence of obesity in the pregnant population. In addition, chronic inflammatory diseases, which are more common in women, may contribute to greater rates of acute myocardial infarction (AMI). Pregnancy itself seems to be a risk factor for AMI, although the exact mechanisms are not clear. AMI in pregnancy should be investigated in the same manner as in the non-pregnant population, not allowing for delays, with investigations being conducted as they would outside of pregnancy. Maternal morbidity following AMI is high as a result of increased rates of heart failure, arrhythmia and cardiogenic shock. Delivery in women with history of AMI should be typically guided by obstetric indications not cardiac ones.

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