Maternal Health Matters (MHM): Obesity is potentially the greatest modifiable risk factor for affecting the development of the fetus in high-income countries

The proportion of obese mothers in high income countries like Australia and the US are increasing…..

In the US the proportion of women who were obese increased by almost 50 % during the nineties. ^1,2

60% of pregnant women in South Australia in 2008 were obese!

In some countries prepregnancy obesity has tripled over the last decade. ³

Still birth risk is twice that of normal-weight women! ³

MATERNAL OBESITY DOESN’T JUST CAUSE HEALTH COMPLICATIONS FOR THE MOTHER BUT ALSO LIFELONG CONSEQUENCES TO THE GROWING FETUS!!!

So how does obesity affect the development of the fetus?

Maternal obesity in the first trimester significantly increases the risk of obesity in offspring in later life ⁴. In fact the EVIDENCE IS CLEAR that it is not only the obese physical state of the mother but OVERNUTRITION of the fetus at crucial developmental milestones that affects the unborn child. It is thought that as the fetus attempts to adapt to the influx of macronutrients, particularly fats and sugars from the mother, causes permanent alterations in weight controlling mechanisms of the fetal body like the hypothalamus, and pancreatic inlet cells ⁵. Such changes significantly increase the risk of the offspring becoming obese, suffering from hypertension and developing type 2 diabetes in later life ^6,7.

….WHAT MOTHERS EAT MAY AFFECT THEIR CHILDRENS HEALTH STATUS AS ADULTS…

Welcome to the developmental nutrition hypothesis…..

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This hypothesis outlines the impact of diet during pregnancy on the health outcomes of the fetus in later life. So on the other side of the scale…..

There are also increased risks of neural tube defects in developing fetuses of obese women. It is thought that the nutritional requirements to maintain an obese body may result in deficiencies of micronutrients to the growing fetus particularly if the mother is not eating a well-balanced diet.⁸^,

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The ability for a mother to dramatically alter the outcomes for her offspring will be examined in further detail in a related post. THERE IS HOPE!

References

1. Mokdad AH, Serdula MK, Dietz WH, Bowman BA, Marks JS, Koplan JP. The spread of the obesity epidemic in the United States, 1991-1998. JAMA. 1999 Oct 27;282(16):1519-22.

2. Mokdad AH, Ford ES, Bowman BA, Nelson DE, Engelgau MM, Vinicor F, et al. Diabetes trends in the U.S.: 1990-1998. Diabetes Care. 2000 Sep;23(9):1278-83.

3. Chu SY, Kim SY, Lau J, Schmid CH, Dietz PM, Callaghan WM, et al. Maternal obesity and risk of stillbirth: a metaanalysis. Am J Obstet Gynecol. 2007 Sep;197(3):223-8.

4. Whitaker RC. Predicting preschooler obesity at birth: the role of maternal obesity in early pregnancy. Pediatrics. 2004 Jul;114(1):e29-36.

5. Tenenbaum-Gavish K, Hod M. Impact of maternal obesity on fetal health. Fetal Diagn Ther. 2013;34(1):1-7.

6. Muhlhausler BS, Ong ZY. The fetal origins of obesity: early origins of altered food intake. Endocr Metab Immune Disord Drug Targets. 2011 Sep 1;11(3):189-97.

7. Leddy MA, Power ML, Schulkin J. The impact of maternal obesity on maternal and fetal health. Rev Obstet Gynecol. 2008 Fall;1(4):170-8.

8. Waller DK, Mills JL, Simpson JL, Cunningham GC, Conley MR, Lassman MR, et al. Are obese women at higher risk for producing malformed offspring? Am J Obstet Gynecol. 1994 Feb;170(2):541-8.

9. Blomberg MI, Kallen B. Maternal obesity and morbid obesity: the risk for birth defects in the offspring. Birth Defects Res A Clin Mol Teratol. 2010 Jan;88(1):35-40.