The prevalence of overweight and obesity is rising in all parts of the world and among young women it presents a very clear danger during pregnancy. Women who are overweight or who gain excessive weight during pregnancy are at greater risk of complications in pregnancy and labour, and are more likely to lose their child to stillbirth, or themselves die during pregnancy. This narrative review considers the evidence that in addition to increasing risk of poor pregnancy outcomes, obesity has the capacity to programme fetuses to be at greater risk of cardiometabolic disorders later in life. An extensive body of evidence from prospective and retrospective cohorts, and record linkage studies demonstrates associations of maternal obesity and/or gestational diabetes with cardiovascular disease, type-1 and type-2 diabetes. Studies in animals suggest that these associations are underpinned by adaptations that occur in fetal life, which remodel the structures of major organs including the brain, kidney and pancreas.
As exposure to maternal obesity during fetal development also programmes a greater risk of obesity in later life, there is a risk of a transgenerational cycle of obesity and related disorders becoming established. Without significant investment in strategies to break such a cycle, the public health implications of the current rise in maternal obesity could last for a century or more. Maintaining healthy weight prior to and during pregnancy, and following guidance on breast feeding and complementary feeding may reduce the risk of poor health for infants exposed to obesity during fetal life.
Langley‐Evans, S. C. (in press). Early life programming of health and disease: The long‐term consequences of obesity in pregnancy. Journal of Human Nutrition and Dietetics, https://doi.org/10.1111/jhn.13023