Past studies have linked pregnancy complications to maternal obesity. Evidence also links maternal obesity and an unhealthy diet during pregnancy to a poor metabolic outcome for the child. Studies have found that maternal obesity affects the child’s risk of obesity, asthma, stroke, type II diabetes, and heart disease. In addition, there has been a link to poor cognitive performance and the risk of neurodevelopmental disorders. The evidence clearly shows the terrible health implication for the child. Finding mechanisms that can help reverse these effects would help create interventions that can prevent the transmission of these diseases for future generations.
Maternal obesity and its implications
Social changes in the past 45 years have lead to a pandemic of obesity.[1] There has been a significant increase in maternal obesity in the 21st century, specifically in high and middle-income countries. Statistically, the estimated percentage of overweight and obese pregnant women was 21.7% in India and 33% in the United States in the year 2014.[2] It was further globally estimated that pregnant women who were overweight or obese were 8.9 million and 14.6 million, respectively.[3] These stats have definitely increased in the past six years. Obese women of childbearing age can face complications that affect them and their unborn child.[4] Because of obesity, the risk of pregnancy-induced hypertension, pre-eclampsia,[5] gestational diabetes,[6] and c-section delivery is increased. Additionally, maternal obesity may also result in maternal mortality.[7] As a whole, the amount of weight a woman gains during pregnancy is important for good maternal and child outcomes.[8]
Maternal obesity is also associated with higher risk of miscarriage, fetal death, and infant death. Additionally, there is an increased risk for birth defects like cardiac abnormalities.[9] Infants are also prone to neurodevelopmental disorders such as cerebral palsy, ADHD,[10] autism, and cognitive delays.[11] For example, a study found that mothers who had been overweight or obese before the pregnancy were twice as likely to report their children having been diagnosed with ADHD.[12] This claim was further supported by a study that analyzed MRIs. The study linked two areas in the brain to high body mass index (BMI). These areas play an important role in decision-making and behavior. Disruptions to these regions have been linked to ADHD, autism, and overeating.[13] Maternal obesity is said to increase the risk of obesity and diabetes in offspring.[14] Data has shown that the risk for obesity and diabetes can be due to an alteration in metabolism “during critical windows of prenatal development.”[15] So how can we reduce obesity among women of reproductive age? What strategies can be used to reduce all the health risks associated with maternal obesity?
Breaking the cycle
A study has managed to identify a mechanism that explains how exercise in pregnancy has metabolic health benefits in offspring. The researchers found a link between a protein called SOD3, vitamin D, and adequate exercise.[16] What they found was that the protein acted as a mediator. What the protein does is transmits the positive effects of maternal exercise to offspring. SOD3 is an exercised-induced protein that is found in the placenta. The protein then activates a signal pathway that controls DNA demethylation[17] in the livers of offspring. As a result, this improves aspects of glucose metabolism in offspring. This means that it would decrease the chances of diabetes and in turn obesity. The study found that the link between SOD3 and vitamin D was that vitamin D increases SOD3. It was noted that vitamin D was needed in conjunction to exercise, for it to mediate the expression of SOD3. So a diet high in vitamin D alone does not increase SOD3. This study shows how exercise before and during pregnancy may be the key to better health for future generations.[18]
Conclusion
It is important to focus on the mother-child relationship in utero to influence maternal, fetal, and child health after pregnancy. Studies have linked maternal obesity to poorer metabolic outcomes in offspring. In addition, maternal obesity is linked to increased morbidity and mortality in both women and children. Obese mothers should be treated as high risk and better care should be taken to monitoring these pregnancies. Although the benefits of exercise cannot be denied, there is still a lack of other interventions that manage obesity during pregnancy. Like the above study, future studies should further investigate mechanisms acting in the mother. Advancements in interventions could improve maternal health, reduce infant mortality, premature birth, neurodevelopmental impairment, child obesity, and diabetes. If this epidemic of maternal obesity is not contained, rates of obesity and diabetes will continue to grow.
Reference
Eman M Alfadhli, E. M. (2021). Maternal obesity influences birth weight more than gestational diabetes. BMC Pregnancy and Childbirth, 21. https://doi.org/10.1186/s12884-021- 03571-5
Grieger, J. A., Hutchesson, M. J., Cooray, S. D., Khomami, M. B., Zaman, S., Segan, L., Teede, H., & Moran, L. J. (2021). A review of maternal overweight and obesity and its impact on cardiometabolic outcomes during pregnancy and postpartum. Therapeutic Advances in Reproductive Health, 15. https://doi.org/10.1177/2633494120986544
Harmon, H. M., & Hannon, T. S. (2018). Maternal obesity: a serious pediatric health crisis. Nature Publishing Group, 83 (6). doi:10.1038/pr.2018.50
Kusuyama, J., Alves-Wagner, A. B., Royce H.Conlin, R. H., Makarewicz, N. S., Albertson, B. G., Prince, N. B., Kobayashi, S., Kozuka, C., Møller, M., Bjerre, M., Fuglsang, J., Emily Miele, E., Middelbeek, R. J. W., Xiudong, Y., Xia, Y., Garneau, L., Bhattacharjee, J., Aguer, C., … Laurie J.Goodyear, L. J. (2021). Placental superoxide dismutase 3 mediates benefits of maternal exercise on offspring health. Cell Metabolism, 33 (5). https://doi.org/10.1016/j.cmet.2021.03.004.
Norr, M. E., Hect, J. L., Lenniger, C. J., Van den Heuvel, M., & Thomason, M. E. (2020). An examination of maternal prenatal BMI and human fetal brain development. The Journal of Child Psychology and Psychiatry, 62 (4). https://doi.org/10.1111/jcpp.13301
Robinson, S. L., Ghassabian, A., Sundaram, R., Trinh, M. H., Lin, T. C., Bell, E. M., and Yeung, E. (2020) Parental weight status and offspring behavioral problems and psychiatric symptoms. The Journal of Pediatrics. DOI: 10.1016/j.jpeds.2020.01.016
Williams, C. B., Mackenzie, K. C., & Gahagan, S. (2014). The Effect of Maternal Obesity on the Offspring. Clin Obstet Gynecol, 57(3). doi:10.1097/GRF.0000000000000043
