Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Review Article
  • Published:

Maternal obesity: focus on offspring cardiometabolic outcomes

Abstract

Several human and animal studies have demonstrated that cardiometabolic parameters in infancy, childhood, adolescence and even adulthood are negatively influenced by many factors besides energy imbalance. Interestingly, maternal weight excess both before and during pregnancy seems to be a negative determinant of metabolic and cardiovascular outcomes in the offspring. This review includes both human and animal studies and finally highlights the link between maternal obesity and cardiometabolic disorders in offspring.

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

Similar content being viewed by others

References

  1. Wang Y, Lobstein T. Worldwide trends in childhood overweight and obesity. Int J Pediatr Obes. 2006;1:11–25.

    PubMed  Google Scholar 

  2. Reilly JJ, Ness AR, Sheriff A. Epidemiological and physiological approaches to understanding the etiology of pediatric obesity: finding the needle in the haystack. Pediatr Res. 2007;61:646–52.

    PubMed  Google Scholar 

  3. Pelusi C, Altieri P, Gambineri A, Repaci A, Cavazza C, Fanelli F, et al. Behavioral, socio-environmental, educational and demographic correlates of excess body weight in Italian adolescences and young adults. Nutr Med Cardiovasc Dis. 2019;29:279–89.

    CAS  Google Scholar 

  4. Drake AJ, Reynolds RM. Impact of maternal obesity on offspring obesity and cardiometabolic disease risk. Reproduction. 2010;140:387–98.

    CAS  PubMed  Google Scholar 

  5. Rooney K, Ozanne SE. Maternal over-nutrition and offspring obesity predisposition: targets for preventative interventions. Int J Obes (Lond). 2011;35:883–90.

    CAS  Google Scholar 

  6. Bekkers MB, Brunekreef B, Smit HA, Kerkhof M, Koppelman GH, Oldenwening M, et al. Early-life determinants of total and HDL cholesterol concentrations in 8-year-old children; the PIAMA birth cohort study. PLoS ONE. 2011;6:e25533.

    CAS  PubMed  PubMed Central  Google Scholar 

  7. Boney CM, Verma A, Tucker R, Vohr BR. Metabolic syndrome in childhood: association with birth weight, maternal obesity, and gestational diabetes mellitus. Pediatrics. 2005;115:e290–6.

    PubMed  Google Scholar 

  8. Catalano PM, Farrell K, Thomas A, Huston-Presley L, Mencin P, de Mouzon SH, et al. Perinatal risk factors for childhood obesity and metabolic dysregulation. Am J Clin Nutr. 2009;90:1303–13.

    CAS  PubMed  PubMed Central  Google Scholar 

  9. Fraser A, Tilling K, Macdonald-Wallis C, Sattar N, Brion MJ, Benfield L, et al. Association of maternal weight gain in pregnancy with offspring obesity and metabolic and vascular traits in childhood. Circulation. 2010;121:2557–64.

    PubMed  PubMed Central  Google Scholar 

  10. 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;39:677–85.

    CAS  Google Scholar 

  11. Gaillard R, Steegers EA, Duijts L, Felix JF, Hofman A, Franco OH, et al. Childhood cardiometabolic outcomes of maternal obesity during pregnancy: the Generation R Study. Hypertension. 2014;63:683–91.

    CAS  PubMed  Google Scholar 

  12. Kaar JL, Crume T, Brinton JT, Bischoff KJ, McDuffie R, Dabelea D. Maternal obesity, gestational weight gain, and offspring adiposity: the exploring perinatal outcomes among children study. J Pediatr. 2014;165:509–15.

    PubMed  PubMed Central  Google Scholar 

  13. Whitaker RC. Predicting preschooler obesity at birth: the role of maternal obesity in early pregnancy. Pediatrics. 2004;114:e29–36.

    PubMed  Google Scholar 

  14. Wrotniak BH, Shults J, Butts S, Stettler N. Gestational weight gain and risk of overweight in the offspring at age 7 y in a multicenter, multiethnic cohort study. Am J Clin Nutr. 2008;87:1818–24.

    CAS  PubMed  Google Scholar 

  15. Gillman MW, Rifas-Shiman SL, Kleinman K, Oken E, Rich-Edwards JW, Taveras EM. Developmental origins of childhood overweight: potential public health impact. Obesity (Silver Spring). 2008;16:1651–6.

    Google Scholar 

  16. Li C, Goran MI, Kaur H, Nollen N, Ahluwalia JS. Developmental trajectories of overweight during childhood: role of early life factors. Obesity (Silver Spring). 2007;15:760–71.

    Google Scholar 

  17. Margerison Zilko CE, Rehkopf D, Abrams B. Association of maternal gestational weight gain with short- and long-term maternal and child health outcomes. Am J Obstet Gynecol. 2010;202:574. e1-8.

    PubMed  Google Scholar 

  18. Oken E, Taveras EM, Kleinman KP, Rich-Edwards JW, Gillman MW. Gestational weight gain and child adiposity at age 3 years. Am J Obstet Gynecol. 2007;196:322.e1-8.

    PubMed  PubMed Central  Google Scholar 

  19. Rooney BL, Mathiason MA, Schauberger CW. Predictors of obesity in childhood, adolescence, and adulthood in a birth cohort. Matern Child Health J. 2011;201:1166–75.

    Google Scholar 

  20. Jedrychowski W, Maugeri U, Kaim I, Budzyn-Mrozek D, Flak E, Mroz E, et al. Impact of excessive gestational weight gain in non-smoking mothers on body fatness in infancy and early childhood. Prospective prebirth cohort study in Cracow. J Physiol Pharmacol. 2011;62:55–64.

    CAS  PubMed  Google Scholar 

  21. Crozier SR, Inskip HM, Godfrey KM, Cooper C, Harvey NC, Cole ZA, et al. Southampton Women’s Survey Study Group. Weight gain in pregnancy and childhood body composition: findings from the Southampton Women’s Survey. Am J Clin Nutr. 2010;91:1745–51.

    CAS  PubMed  PubMed Central  Google Scholar 

  22. Lawlor DA, Timpson NJ, Harbord RM, Leary S, Ness A, McCarthy MI, et al. Exploring the developmental overnutrition hypothesis using parental-offspring associations and FTO as an instrumental variable. PLoS Med. 2008;5:e33.

    PubMed  PubMed Central  Google Scholar 

  23. Perng W, Gillman MW, Mantzoros CS, Oken E. A prospective study of maternal prenatal weight and offspring cardiometabolic health in midchildhood. Ann Epidemiol. 2014;24:793–800.e1.

    PubMed  PubMed Central  Google Scholar 

  24. Lemas DJ, Brinton JT, Shapiro AL, Glueck DH, Friedman JE, Dabelea D. Associations of maternal weight status prior and during pregnancy with neonatal cardiometabolic markers at birth: the Healthy Start study. Int J Obes (Lond). 2015;39:1437–42.

    CAS  Google Scholar 

  25. Oostvogels AJ, Stronks K, Roseboom TJ, van der Post JA, van Eijsden M, Vrijkotte TG. Maternal prepregnancy BMI, offspring’s early postnatal growth, and metabolic profile at age 5-6 years: the ABCD Study. J Clin Endocrinol Metab. 2014;99:3845–54.

    CAS  PubMed  Google Scholar 

  26. Tam CH, Wang Y, Luan J, Lee HM, Luk AO, Tutino GE, et al. Maternal history of diabetes is associated with increased cardiometabolic risk in Chinese. Nutr Diabetes. 2014;4:e112.

    CAS  PubMed  PubMed Central  Google Scholar 

  27. Tam CHT, Ma RCW, Yuen LY, Ozaki R, Li AM, Hou Y, et al. The impact of maternal gestational weight gain on cardiometabolic risk factors in children. Diabetologia. 2018;61:2539–48.

    CAS  PubMed  PubMed Central  Google Scholar 

  28. Dodd JM, McPhee AJ, Turnbull D, Yelland LN, Deussen AR, Grivell RM, et al. The effects of antenatal dietary and lifestyle advice for women who are overweight or obese on neonatal health outcomes: the LIMIT randomised trial. BMC Med. 2014;12:163. LIMIT Randomised Trial Group.

    PubMed  PubMed Central  Google Scholar 

  29. 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.

    Google Scholar 

  30. Gaillard R, Welten M, Oddy WH, 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;123:207–16.

    CAS  PubMed  Google Scholar 

  31. Groth SW, Holland ML, Smith JA, Meng Y, Kitzman H. Effect of Gestational Weight Gain and Prepregnancy Body Mass Index in Adolescent Mothers on Weight and Body Mass Index of Adolescent Offspring. J Adolesc Health. 2017;61:626–33.

    PubMed  PubMed Central  Google Scholar 

  32. Hrolfsdottir L, Rytter D, Olsen SF, Bech BH, Maslova E, Henriksen TB, et al. Gestational weight gain in normal weight women and offspring cardio-metabolic risk factors at 20 years of age. Int J Obes. 2015;39:671–6.

    CAS  Google Scholar 

  33. Laura HC, Menezes AB, Noal RB, Hallal PC, Araujo CL. Maternal anthropometric characteristics in pregnancy and blood pressure among adolescents: 1993 live birth cohort, Pelotas, southern Brazil. BMC Public Health. 2010;10:434–24.

    PubMed  PubMed Central  Google Scholar 

  34. Oken E, Rifas-Shiman SL, Field AE, Frazier AL, Gillman MW. Maternal gestational weight gain and offspring weight in adolescence. Obstet Gynecol. 2008;112:999–1006.

    PubMed  PubMed Central  Google Scholar 

  35. Stuebe AM, Forman MR, Michels KB. Maternal-recalled gestational weight gain, pre-pregnancy body mass index, and obesity in the daughter. Int J Obes (Lond). 2009;33:743–52.

    CAS  Google Scholar 

  36. Tequeanes AL, Gigante DP, Assunção MC, Chica DA, Horta BL. Maternal anthropometry is associated with the body mass index and waist:height ratio of offspring at 23 years of age. J Nutr. 2009;139:750–4.

    CAS  PubMed  Google Scholar 

  37. Schack-Nielsen L, Michaelsen KF, Gamborg M, Mortensen EL, Sorensen TI. Gestational weight gain in relation to offspring body mass index and obesity from infancy through adulthood. Int J Obes. 2010;34:67–74.

    CAS  Google Scholar 

  38. Laitinen J, Power C, Järvelin MR. Family social class, maternal body mass index, childhood body mass index, and age at menarche as predictors of adult obesity. Am J Clin Nutr. 2001;74:287–94.

    CAS  PubMed  Google Scholar 

  39. Eriksson JG, Sandboge S, Salonen M, Kajantie E, Osmond C. Maternal weight in pregnancy and offspring body composition in late adulthood: findings from the Helsinki Birth Cohort Study (HBCS). Ann Med. 2015;47:94–9.

    PubMed  Google Scholar 

  40. Hochner H, Friedlander Y, Calderon-Margalit R, Meiner V, Sagy Y, Avgil-Tsadok M, et al. Associations of maternal prepregnancy body mass index and gestational weight gain with adult offspring cardiometabolic risk factors: the Jerusalem Perinatal Family Follow-up Study. Circulation. 2012;125:1381–9.

    CAS  PubMed  PubMed Central  Google Scholar 

  41. Reynolds RM, Osmond C, Phillips DI, Godfrey KM. Maternal BMI, parity, and pregnancy weight gain: influences on offspring adiposity in young adulthood. J Clin Endocrinol Metab. 2010;95:5365–9.

    CAS  PubMed  Google Scholar 

  42. Reynolds RM, Allan KM, Raja EA, Bhattacharya S, McNeill G, Hannaford PC, et al. Maternal obesity during pregnancy and premature mortality from cardiovascular event in adult offspring: follow-up of 1 323 275 person years. BMJ. 2013;347:f4539.

    PubMed  PubMed Central  Google Scholar 

  43. Menting MD, Mintjens S, van de Beek C, Frick CJ, Ozanne SE, Limpens J, et al. Maternal obesity in pregnancy impacts offspring cardiometabolic health: Systematic review and meta-analysis of animal studies. Obes Rev. 2019;20:675–85.

    CAS  PubMed  PubMed Central  Google Scholar 

  44. Samuelsson AM, Matthews PA, Argenton M, Christie MR, McConnell JM, Jansen EH, et al. Diet-induced obesity in female mice leads to offspring hyperphagia, adiposity, hypertension, and insulin resistance: a novel murine model of developmental programming. Hypertension. 2008;51:383–92.

    CAS  PubMed  Google Scholar 

  45. Samuelsson AM, Morris A, Igosheva N, Kirk SL, Pombo JM, Coen CW, et al. Evidence for sympathetic origins of hypertension in juvenile offspring of obese rats. Hypertension. 2010;55:76–82.

    CAS  PubMed  Google Scholar 

  46. Elahi MM, Cagampang FR, Mukhtar D, Anthony FW, Ohri SK, Hanson MA. Long-term maternal high-fat feeding from weaning through pregnancy and lactation predisposes offspring to hypertension, raised plasma lipids and fatty liver in mice. Br J Nutr. 2009;102:514–9.

    CAS  PubMed  Google Scholar 

  47. Simonds SE, Pryor JT, Ravussin E, Greenway FL, Dileone R, Allen AM, et al. Leptin mediates the increase in blood pressure associated with obesity. Cell. 2014;159:1404–16.

    CAS  PubMed  PubMed Central  Google Scholar 

  48. Zhang YP, Huo YL, Fang ZQ, Wang XF, Li JD, Wang HP, et al. Maternal high-fat diet acts on the brain to induce baroreflex dysfunction and sensitization of angiotensin II-induced hypertension in adult offspring. Am J Physiol Heart Circ Physiol. 2018;314:H1061–9.

    CAS  PubMed  PubMed Central  Google Scholar 

  49. Khan IY, Taylor PD, Dekou V, Seed PT, Lakasing L, Graham D, et al. Gender-linked hypertension in offspring of lard-fed pregnant rats. Hypertension. 2003;41:168–75.

    CAS  PubMed  Google Scholar 

  50. Qiao L, Guo Z, Bosco C, Guidotti S, Wang Y, Wang M, et al. Maternal high-fat feeding increases placental lipoprotein lipase activity by reducing SIRT1 expression in mice. Diabetes. 2015;64:3111–20.

    CAS  PubMed  PubMed Central  Google Scholar 

  51. Ford SP, Zhang L, Zhu M, Miller MM, Smith DT, Hess BW, et al. Maternal obesity accelerates fetal pancreatic beta-cell but not alpha-cell development in sheep: prenatal consequences. Am J Physiol Regul Integr Comp Physiol. 2009;297:R835–43.

    CAS  PubMed  PubMed Central  Google Scholar 

  52. Gheorghe CP, Goyal R, Holweger JD, Longo LD. Placental gene expression responses to maternal protein restriction in the mouse. Placenta. 2009;30:411–7.

    CAS  PubMed  PubMed Central  Google Scholar 

  53. Aagaard-Tillery KM, Grove K, Bishop J, Ke X, Fu Q, McKnight R, et al. Developmental origins of disease and determinants of chromatin structure: maternal diet modifies the primate fetal epigenome. J Mol Endocrinol. 2008;41:91–102.

    CAS  PubMed  PubMed Central  Google Scholar 

  54. Vucetic Z, Kimmel J, Totoki K, Hollenbeck E, Reyes TM. Maternal high-fat diet alters methylation and gene expression of dopamine and opioid-related genes. Endocrinology. 2010;151:4756–64.

    CAS  PubMed  PubMed Central  Google Scholar 

  55. Drummond EM, Gibney ER. Epigenetic regulation in obesity. Curr Opin Clin Nutr Metab Care. 2013;16:392–7.

    CAS  PubMed  Google Scholar 

Download references

Acknowledgements

Obesity Programs of nutrition, Education, Research and Assessment (OPERA) group members served as collaborators and approved the final version of the manuscript: Colao Annamaria, Savastano Silvia, Barrea Luigi, Muscogiuri Giovanna, Alviggi Carlo, Angrisani Luigi, Annunziata Giuseppe, Beguinot Francesco, Belfiore Annamaria, Belfiore Antonino, Bellastella Giuseppe, Biondi Bernadette, Bonaduce Domenico, Bordoni Laura, Brasacchio Caterina, Capaldo Brunella, Caprio Massimiliano, Cataldi Mauro, Cignarelli Angelo, Cittadini Antonello, Conforti Alessandro, Cuomo Rosario, De Placido Giuseppe, De Siena Marina, Di Carlo Costantino, Di Luigi Luigi, Di Nisio Andrea, Di Renzo Laura, Di Somma Carolina, Docimo Ludovico, Donini Lorenzo Maria, Federici Massimo, Foresta Carlo, Gabbianelli Rosita, Gambineri Alessandra, Gastaldelli Amalia, Giallauria Francesco, Giardiello Cristiano, Gnessi Lucio, Guida Brunella, Laudisio Daniela, Lenzi Andrea, Macchia Paolo Emidio, Manno Emilio, Marzullo Paolo, Migliaccio Silvia, Muratori Fabrizio, Musella Mario, Nardone Gerardo, Nicasto Vincenzo, Piazza Luigi, Pilone Vincenzo, Pivari Francesca, Pivonello Rosario, Pugliese Gabriella, Riccardi Gabriele, Ritieni Alberto, Salzano Ciro, Sanduzzi Alessandro, Sbraccia Paolo, Sesti Giorgio, Soldati Laura, Taglialatela Maurizio, Trimarco Bruno, Tuccinardi Dario.

Funding

The 2019 OPERA meeting was organized by Panta Rei Srl and sponsored by Novo Nordisk, Therascience, Bruno Pharma, Merck, Savio Pharma Italia Srl, IBSA Institut Biochimique SA, Bioitalia Srl, Cohesion Pharmaceutical, and Specchiasol Srl. Publication of this article as part of a supplement was sponsored by Panta Rei Srl, Naples, Italy. The meeting sponsors and organizer did not have access to the manuscripts and the authors maintained control of the content.

Author information

Authors and Affiliations

Authors

Consortia

Contributions

The authors’ responsibilities were as follows: AG, AC, ADN and DL: were responsible for the concept of this paper and drafted the manuscript; GM, LB, SS and AC: provided a critical review of the paper. OPERA Group members participated to the revision of the manuscript. All authors and OPERA Group Members contributed to and agreed on the final version of the manuscript.

Corresponding author

Correspondence to Alessandra Gambineri.

Ethics declarations

Conflict of interest

A Conforti received consulting fees from Merck Serono S.p.A. The remaining authors have nothing to disclose.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Gambineri, A., Conforti, A., Di Nisio, A. et al. Maternal obesity: focus on offspring cardiometabolic outcomes. Int J Obes Supp 10, 27–34 (2020). https://doi.org/10.1038/s41367-020-0016-2

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/s41367-020-0016-2

This article is cited by

Search

Quick links