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Obesity and pregnancy, the perfect metabolic storm

European Journal of Clinical Nutrition volume 75, pages 1723–1734 (2021)Cite this article

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Abstract

Pregnancy is a physiological stress that requires dynamic, regulated changes affecting maternal and fetal adiposity. Excessive accumulation of dysfunctional adipose tissue defined by metabolic and molecular alterations cause severe health consequences for mother and fetus. When subjected to sustained overnutrition, the cellular and lipid composition of the adipose tissue changes predisposing to insulin resistance, diabetes, and other metabolic disorders compromising the outcome of the pregnancy. Moreover, excessive maternal weight gain, usually in the context of obesity, predisposes to an increased flux of nutrients from mother to fetus throughout the placenta. The fetus of an obese mother will accumulate more adiposity and may increase the risk of future metabolic disorder later in life. Thus, further understanding of the interaction between maternal metabolism, epigenetic regulation of the adipose tissue, and their transgenerational transfer are required to mitigate the adverse health outcomes for the mother and the fetus associated with maternal obesity.

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Fig. 1: Classification of phenotypes according to body mass index and metabolic health.
Fig. 2: Alterations occurring in adipose tissue during obesity.
Fig. 3: Negative consequences of obesity before pregnancy and during gestation.
Fig. 4: The interaction of maternal obesity effects on placenta and fetus and its consequences for the offspring in adult life from an epigenetic point of view.

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Funding

Research conducted for this publication was supported by Ministerio de Economía y Competitividad de España (BFU2013-47384-F, BFU2016-78951-R, BFU2017-90578-REDT), Comunidad de Madrid (Spain) (B2017/BMD-3684) and Karolinska Institutet and MRC.

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  1. Área de Bioquímica y Biología Molecular, Departamento de Ciencias Básicas de la Salud, Facultad de Ciencias de la Salud, Universidad Rey Juan Carlos, Madrid, Spain

    Patricia Corrales & Gema Medina-Gómez

  2. Metabolic Research Laboratories, Wellcome Trust MRC Institute of Metabolic Science, University of Cambridge, Addenbrooke’s Hospital, Cambridge, UK

    Antonio Vidal-Puig

  3. Wellcome Trust Sanger Institute, Hinxton, UK

    Antonio Vidal-Puig

  4. Cambridge University Nanjing Centre of Technology and Innovation, Nanjing, PR China

    Antonio Vidal-Puig

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PC, AVP, and GMG wrote the paper.

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Corrales, P., Vidal-Puig, A. & Medina-Gómez, G. Obesity and pregnancy, the perfect metabolic storm. Eur J Clin Nutr 75, 1723–1734 (2021). https://doi.org/10.1038/s41430-021-00914-5

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