Vol 91, No 12 (2020)
Review paper
Published online: 2020-12-31
How mother’s obesity may affect the pregnancy and offspring
, 1, 1
Abstract
One of the main reasons for the epidemic of obesity, which has already influenced the economic condition of health system
worldwide, is our modern lifestyle having an unbalanced calorie intake and insufficient physical activity. Maternal-fetal nourishment
and metabolism are the mechanisms of fetal programming of obesity-adiposity and non-communicable diseases
that have been most extensively investigated. A mother’s obesity is related to adverse outcomes for both mother and baby.
Maternal overnutrition is also associated with a higher risk of gestational diabetes, preterm birth, large-for-gestational-age
babies, fetal defects, congenital anomalies, and perinatal death. Women with obesity should be encouraged to reduce their
body mass index (BMI) prior to pregnancy, and to limit weight gain during pregnancy. Obstetric ultrasound imaging in
pregnant women is negatively affected by abdominal adipose tissue, having an adverse influence on congenital anomaly
detection rates and the estimation of fetal weight.
Keywords: obesitybody mass indexBMIgestational diabetes mellitusGDMpregnancyglucose intolerancefolatesvitamin Bhomocysteine
References
- Malik VS, Willett WC, Hu FB. Global obesity: trends, risk factors and policy implications. Nat Rev Endocrinol. 2013; 9(1): 13–27.
- Poston L, Caleyachetty R, Cnattingius S, et al. Preconceptional and maternal obesity: epidemiology and health consequences. Lancet Diabetes Endocrinol. 2016; 4(12): 1025–1036.
- Diagnosis and Classification of Diabetes Mellitus. Diabetes Care. 2009; 33(Supplement_1): S62–S69.
- Philipps LH, Santhakumaran S, Gale C, et al. The diabetic pregnancy and offspring BMI in childhood: a systematic review and meta-analysis. Diabetologia. 2011; 54(8): 1957–1966.
- Delhaes F, Giza SA, Koreman T, et al. Altered maternal and placental lipid metabolism and fetal fat development in obesity: Current knowledge and advances in non-invasive assessment. Placenta. 2018; 69: 118–124.
- Dabelea D, Crume T. Maternal environment and the transgenerational cycle of obesity and diabetes. Diabetes. 2011; 60(7): 1849–1855.
- Frias AE, Grove KL. Obesity: a transgenerational problem linked to nutrition during pregnancy. Semin Reprod Med. 2012; 30(6): 472–478.
- Lisonkova S, Muraca GM, Potts J, et al. Association Between Prepregnancy Body Mass Index and Severe Maternal Morbidity. JAMA. 2017; 318(18): 1777–1786.
- Santos S, Voerman E, Amiano P, et al. Impact of maternal body mass index and gestational weight gain on pregnancy complications: an individual participant data meta‐analysis of European, North American and Australian cohorts. BJOG. 2019; 126(8): 984–995.
- Saravanan P, Yajnik C. Role of maternal vitamin B12 on the metabolic health of the offspring: a contributor to the diabetes epidemic? The British Journal of Diabetes & Vascular Disease. 2010; 10(3): 109–114.
- Adaikalakoteswari A, Jayashri R, Sukumar N, et al. Vitamin B12 deficiency is associated with adverse lipid profile in Europeans and Indians with type 2 diabetes. Cardiovasc Diabetol. 2014; 13: 129.
- Stewart CP, Christian P, Schulze KJ, et al. Low maternal vitamin B-12 status is associated with offspring insulin resistance regardless of antenatal micronutrient supplementation in rural Nepal. J Nutr. 2011; 141(10): 1912–1917.
- Adaikalakoteswari A, Vatish M, Lawson A, et al. Low maternal vitamin B12 status is associated with lower cord blood HDL cholesterol in white Caucasians living in the UK. Nutrients. 2015; 7(4): 2401–2414.
- Knight BA, Shields BM, Brook A, et al. Lower Circulating B12 Is Associated with Higher Obesity and Insulin Resistance during Pregnancy in a Non-Diabetic White British Population. PLoS One. 2015; 10(8): e0135268.
- Sukumar N, Venkataraman H, Wilson S, et al. Vitamin B12 Status among Pregnant Women in the UK and Its Association with Obesity and Gestational Diabetes. Nutrients. 2016; 8(12).
- Selhub J, Rosenberg IH. Excessive folic acid intake and relation to adverse health outcome. Biochimie. 2016; 126: 71–78.
- Radzicka S, Ziolkowska K, Zaborowski MP, et al. Serum homocysteine and vitamin B12 levels in women with gestational diabetes mellitus. Ginekol Pol. 2019; 90(7): 381–387.
- Meigs JB, Jacques PF, Selhub J, et al. Framingham Offspring Study. Fasting plasma homocysteine levels in the insulin resistance syndrome: the Framingham offspring study. Diabetes Care. 2001; 24(8): 1403–1410.
- Patterson S, Flatt PR, Brennan L, et al. Detrimental actions of metabolic syndrome risk factor, homocysteine, on pancreatic beta-cell glucose metabolism and insulin secretion. J Endocrinol. 2006; 189(2): 301–310.
- Page KA, Romero A, Buchanan TA, et al. Gestational diabetes mellitus, maternal obesity, and adiposity in offspring. J Pediatr. 2014; 164(4): 807–810.
- Pitchika A, Vehik K, Hummel S, et al. TEDDY study group. Associations of Maternal Diabetes During Pregnancy with Overweight in Offspring: Results from the Prospective TEDDY Study. Obesity (Silver Spring). 2018; 26(9): 1457–1466.
- HAPO Study Cooperative Research Group. Hyperglycaemia and Adverse Pregnancy Outcome (HAPO) Study: associations with maternal body mass index. BJOG. 2010; 117(5): 575–584.
- Lowe Jr WL, Scholtens DM, Lowe LP, et al. Association of Gestational Diabetes With Maternal Disorders of Glucose Metabolism and Childhood Adiposity. JAMA. 2018; 320(10): 1005–1016.
- Berglund SK, García-Valdés L, Torres-Espinola FJ, et al. PREOBE team. Maternal, fetal and perinatal alterations associated with obesity, overweight and gestational diabetes: an observational cohort study (PREOBE). BMC Public Health. 2016; 16: 207.
- Lawlor DA, Fraser A, Lindsay RS, et al. Association of existing diabetes, gestational diabetes and glycosuria in pregnancy with macrosomia and offspring body mass index, waist and fat mass in later childhood: findings from a prospective pregnancy cohort. Diabetologia. 2010; 53(1): 89–97.
- Krishnaveni GV, Veena SR, Hill JC, et al. Intrauterine exposure to maternal diabetes is associated with higher adiposity and insulin resistance and clustering of cardiovascular risk markers in Indian children. Diabetes Care. 2010; 33(2): 402–404.
- Crume TL, Ogden L, West NA, et al. Association of exposure to diabetes in utero with adiposity and fat distribution in a multiethnic population of youth: the Exploring Perinatal Outcomes among Children (EPOCH) Study. Diabetologia. 2011; 54(1): 87–92.
- Wright CS, Rifas-Shiman SL, Rich-Edwards JW, et al. Intrauterine exposure to gestational diabetes, child adiposity, and blood pressure. Am J Hypertens. 2009; 22(2): 215–220.
- Bergman RN, Kim SP, Catalano KJ, et al. Why visceral fat is bad: mechanisms of the metabolic syndrome. Obesity (Silver Spring). 2006; 14 Suppl 1: 16S–19S.
- Wolfe KB, Rossi RA, Warshak CR. The effect of maternal obesity on the rate of failed induction of labor. Am J Obstet Gynecol. 2011; 205(2): 128.e1–128.e7.
- Goetzinger KR, Tuuli MG, Odibo AO, et al. Screening for fetal growth disorders by clinical exam in the era of obesity. J Perinatol. 2013; 33(5): 352–357.
- Kritzer S, Magner K, Warshak CR. Increasing maternal body mass index and the accuracy of sonographic estimation of fetal weight near delivery. J Ultrasound Med. 2014; 33(12): 2173–2179.
- Hendler I, Blackwell SC, Bujold E, et al. Suboptimal second-trimester ultrasonographic visualization of the fetal heart in obese women: should we repeat the examination? J Ultrasound Med. 2005; 24(9): 1205–9; quiz 1210.
- Aksoy H, Aksoy Ü, Karadağ Öİ, et al. Influence of maternal body mass index on sonographic fetal weight estimation prior to scheduled delivery. J Obstet Gynaecol Res. 2015; 41(10): 1556–1561.
- Field NT, Piper JM, Langer O. The effect of maternal obesity on the accuracy of fetal weight estimation. Obstet Gynecol. 1995; 86(1): 102–107.
- Farrell T, Holmes R, Stone P. The effect of body mass index on three methods of fetal weight estimation. BJOG. 2002; 109(6): 651–657.
- Dashe JS, McIntire DD, Twickler DM. Maternal obesity limits the ultrasound evaluation of fetal anatomy. J Ultrasound Med. 2009; 28(8): 1025–1030.
- Aagaard-Tillery KM, Flint Porter T, Malone FD, et al. Influence of maternal BMI on genetic sonography in the FaSTER trial. Prenat Diagn. 2010; 30(1): 14–22.
- Fuchs F, Houllier M, Voulgaropoulos A, et al. Factors affecting feasibility and quality of second-trimester ultrasound scans in obese pregnant women. Ultrasound Obstet Gynecol. 2013; 41(1): 40–46.
- Caradeux J, Eixarch E, Mazarico E, et al. Second- to Third-Trimester Longitudinal Growth Assessment for the Prediction of Largeness for Gestational Age and Macrosomia in an Unselected Population. Fetal Diagn Ther. 2018; 43(4): 284–290.
- Tarca AL, Hernandez-Andrade E, Ahn H, et al. Single and Serial Fetal Biometry to Detect Preterm and Term Small- and Large-for-Gestational-Age Neonates: A Longitudinal Cohort Study. PLoS One. 2016; 11(11): e0164161.
- Hart NC, Hilbert A, Meurer B, et al. Macrosomia: a new formula for optimized fetal weight estimation. Ultrasound Obstet Gynecol. 2010; 35(1): 42–47.
- Khouly NEl, Elkelani O, Saleh S. Amniotic fluid index and estimated fetal weight for prediction of fetal macrosomia: a prospective observational study. J Matern Fetal Neonatal Med. 2016; 30(16): 1948–1952.
- Duryea EL, Casey BM, McIntire DD, et al. The FL/AC ratio for prediction of shoulder dystocia in women with gestational diabetes. J Matern Fetal Neonatal Med. 2017; 30(19): 2378–2381.
