Parental obesity

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Maternal obesity refers to obesity (often including being overweight) of a woman during pregnancy. Parental obesity refers to obesity of either parent during pregnancy.

Contents

Maternal obesity has a significant impact on maternal metabolism and offspring development. [1] Insulin resistance, glucose homeostasis, fat oxidation and amino acid synthesis are all disrupted by maternal obesity and contribute to adverse outcomes. [1] Modification of lifestyle is an effective intervention strategy for improvement of maternal metabolism and the prevention of adverse outcomes. [1]

Obesity is defined as having a Body Mass Index (BMI) of 30 or greater. A 5-foot-5-inch tall woman would be considered obese if she weighs 180 pounds or more and a 5-foot-8-inch tall woman would be considered obese if she weighs 200 pounds or more. [2]

Effects on the fetus

Defects/ impairments

Between 18 and 38% of pregnant women of American women are classified as obese. However, little is known about the link between maternal obesity and diabetic effects in offspring. Maternal obesity is associated with increased odds of pregnancies affected by congenital anomalies, including neural tube defects and spina bifida. [3] The chances of having neural tube defects in the newborn of an obese woman has been shown to be twice that of a non-obese pregnant female. [2] Some other anomalies that were increased among mothers with obesity included septal anomalies, cleft palate, cleft lip and palate, anorectal atresia, hydrocephaly, and limb reduction anomalies. Babies are also more likely to be admitted to neonatal intensive care units because of effects from the obese mother. Each year, nearly 2,500 babies are born[ where? ] with these defects, and many other affected pregnancies end in miscarriage and stillbirth. [3]

Mental or physical effects on the fetus

Maternal obesity is linked with elective preterm delivery, neonatal death, and delivery of an extremely low birth weight infant. In follow-up studies of babies whose birth weights were below 1000g, it was shown that 40% to 45% of the survivors had severe neurodevelopmental impairments. [4]

It has been demonstrated through a study on rats that when a pregnant mother ate a diet rich in fat, sugar, and salt, that mother's offspring was more likely to overeat and have a preference for junk food. Even when the offspring were not given the option of junk food, their bodies metabolized food differently from offspring whose mother ate healthier. Offspring of mothers who ate badly had higher levels of cholesterol and triglycerides in their bloodstream and higher risk of heart disease. In addition, these offspring had higher levels of glucose and insulin, which indicate development of type 2 diabetes. The rats were studied through adulthood and were found to be fatter than the offspring whose mothers ate healthier. This study showed that the diet of mothers not only affects the offspring's chemical physiology but also their likelihood of becoming even more unhealthy through their natural preference to bad habits. [5]

Paternal obesity effects on the fetus

Researchers from the NIH's National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) conducted a study and found that early-onset paternal obesity is connected with an increased risk of liver disease in their kin. Researchers found that obese fathers had an elevated level of serum alanine aminotransferase (ALT), a liver enzyme, compared to fathers who were not obese. They did a secondary analysis that excluded obese offspring. Children who were a normal weight but had obese fathers still had elevated ALT levels, which indicated that a child's ALT levels are not dependent upon the child's own BMI. [6]

Obesity effects on the mother

Disease

Obese women have an increased risk of pregnancy-related complications, including hypertension, gestational diabetes, and blood clots. Also, the mother is at risk of going into preterm labor. [7] [2] Maternal obesity is also known to be associated with increased rates of complications in late pregnancy such as cesarean delivery, and shoulder dystocia. [4] A meta-analysis estimated that Cesarean delivery rates increased with odds ratios of 1.5 among overweight, 2 among obese, and 3 among severely obese women, compared with normal weight pregnant women. [8] In addition, morbidly obese women who have not had children before are at increased risk of all–cause preterm deliveries. It is well recognized that obese women are at increased risk of preeclampsia and that women who have never been pregnant are at higher risk of preeclampsia than women who have had children in the past. [4] Obesity in pregnancy is also known to be associated with hyperinsulinemia, dyslipidemia, impaired endothelial function, and up-regulated markers of inflammation. [9] [10] [11]

Effects of negative diets

Poor glycemic control can lead to neural tube defects. The usual increase in insulin resistance seen in late pregnancy is enhanced in obese mothers, causing a postprandial increase in glucose, lipids, and amino acids, as well as excessive fetal exposure to fuel sources.[ clarification needed ][ citation needed ] This, in turn, increases fetal size, fat storage, and potential risk for disease. For mothers, impaired glucose tolerance and hyperlipidemia are more common among obese mothers.

Modifying the risks

There are many options available in treating obesity, such as: altering one's diet and exercising regularly. Moderate forms of exercise, such as walking, can lead to healthy weight loss. Some people who are obese turn to gastric bypass surgery in order to reduce their appetites. It is always advised to consult a physician regarding any obesity treatment.

It is recommended that obese women should try to lose weight before becoming pregnant, yet women should not diet during pregnancy because sufficient nutrition is important for pregnant women and women planning pregnancy. Women with gastric banding can have normal pregnancies and better outcomes than women who do not have the surgery, but in most cases, doctors have agreed that pregnancy should wait until surgery-related weight loss has stabilized. Clinicians have been encouraged to talk to women who are pregnant or may become pregnant about getting enough folic acid, quitting smoking, and avoiding alcohol. Women are also recommended to have appropriate calorie intake and exercise adequately.

Nutrition recommendations

Pregnant women who ate more sweets, such as candy and processed juices, in early pregnancy were at higher risk of gaining excessive weight. A healthy, well-balanced diet during pregnancy can also help to minimize some pregnancy symptoms such as nausea and constipation. [12]

Exercise recommendations

During pregnancy, doctors recommend light exercise. Doctors state that exercise can help the comfort of the mother and the well-being of the unborn child. Some benefits include, but are not limited to: reduced back pain, decrease in constipation, less likely to gain excess weight, decreased chance of gestational diabetes, easier labor, quicker recovery, and better physical and emotional health of the baby. [13]

If negative signs and symptoms occur after exercising, pregnant females should stop immediately. Some signs include: dizziness, faintness, headache, shortness of breath, uterine contractions, vaginal bleeding, fluid leaking, or heart palpitations.

Related Research Articles

<span class="mw-page-title-main">Multiple birth</span> End of a multiple pregnancy where two or more offspring are born

A multiple birth is the culmination of one multiple pregnancy, wherein the mother gives birth to two or more babies. A term most applicable to vertebrate species, multiple births occur in most kinds of mammals, with varying frequencies. Such births are often named according to the number of offspring, as in twins and triplets. In non-humans, the whole group may also be referred to as a litter, and multiple births may be more common than single births. Multiple births in humans are the exception and can be exceptionally rare in the largest mammals.

<span class="mw-page-title-main">Gestational diabetes</span> Medical condition

Gestational diabetes is a condition in which a woman without diabetes develops high blood sugar levels during pregnancy. Gestational diabetes generally results in few symptoms; however, it increases the risk of pre-eclampsia, depression, and of needing a Caesarean section. Babies born to mothers with poorly treated gestational diabetes are at increased risk of macrosomia, of having hypoglycemia after birth, and of jaundice. If untreated, diabetes can also result in stillbirth. Long term, children are at higher risk of being overweight and of developing type 2 diabetes.

<span class="mw-page-title-main">Placental abruption</span> Medical condition

Placental abruption is when the placenta separates early from the uterus, in other words separates before childbirth. It occurs most commonly around 25 weeks of pregnancy. Symptoms may include vaginal bleeding, lower abdominal pain, and dangerously low blood pressure. Complications for the mother can include disseminated intravascular coagulopathy and kidney failure. Complications for the baby can include fetal distress, low birthweight, preterm delivery, and stillbirth.

<span class="mw-page-title-main">Pregnancy</span> Time of offspring development in mothers body

Pregnancy is the time during which one or more offspring develops (gestates) inside a woman's uterus (womb). A multiple pregnancy involves more than one offspring, such as with twins.

<span class="mw-page-title-main">Large for gestational age</span> Medical condition

Large for gestational age (LGA) is a term used to describe infants that are born with an abnormally high weight, specifically in the 90th percentile or above, compared to other babies of the same developmental age. Macrosomia is a similar term that describes excessive birth weight, but refers to an absolute measurement, regardless of gestational age. Typically the threshold for diagnosing macrosomia is a body weight between 4,000 and 4,500 grams, or more, measured at birth, but there are difficulties reaching a universal agreement of this definition.

<span class="mw-page-title-main">Birth weight</span> Weight of a human baby at birth

Birth weight is the body weight of a baby at their birth. The average birth weight in babies of European and African descent is 3.5 kilograms (7.7 lb), with the normative range between 2.5 and 4.0 kilograms. On average, babies of Asian descent weigh about 3.25 kilograms (7.2 lb). The prevalence of low birth weight has changed over time. Trends show a slight decrease from 7.9% (1970) to 6.8% (1980), then a slight increase to 8.3% (2006), to the current levels of 8.2% (2016). The prevalence of low birth weights has trended slightly upward from 2012 to the present.

<span class="mw-page-title-main">Complications of pregnancy</span> Medical condition

Complications of pregnancy are health problems that are related to, or arise during pregnancy. Complications that occur primarily during childbirth are termed obstetric labor complications, and problems that occur primarily after childbirth are termed puerperal disorders. While some complications improve or are fully resolved after pregnancy, some may lead to lasting effects, morbidity, or in the most severe cases, maternal or fetal mortality.

<span class="mw-page-title-main">Diabetes and pregnancy</span> Effects of pre-existing diabetes upon pregnancy

For pregnant women with diabetes, some particular challenges exist for both mother and fetus. If the pregnant woman has diabetes as a pre-existing disorder, it can cause early labor, birth defects, and larger than average infants. Therefore, experts advise diabetics to maintain blood sugar level close to normal range about 3 months before planning for pregnancy.

Maternal health is the health of women during pregnancy, childbirth, and the postpartum period. In most cases, maternal health encompasses the health care dimensions of family planning, preconception, prenatal, and postnatal care in order to ensure a positive and fulfilling experience. In other cases, maternal health can reduce maternal morbidity and mortality. Maternal health revolves around the health and wellness of pregnant women, particularly when they are pregnant, at the time they give birth, and during child-raising. WHO has indicated that even though motherhood has been considered as a fulfilling natural experience that is emotional to the mother, a high percentage of women develop health problems and sometimes even die. Because of this, there is a need to invest in the health of women. The investment can be achieved in different ways, among the main ones being subsidizing the healthcare cost, education on maternal health, encouraging effective family planning, and ensuring progressive check up on the health of women with children. Maternal morbidity and mortality particularly affects women of color and women living in low and lower-middle income countries.

Metabolic imprinting refers to the long-term physiological and metabolic effects that an offspring's prenatal and postnatal environments have on them. Perinatal nutrition has been identified as a significant factor in determining an offspring's likelihood of it being predisposed to developing cardiovascular disease, obesity, and type 2 diabetes amongst other conditions.

<span class="mw-page-title-main">Circumvallate placenta</span> Medical condition

Circumvallate placenta is a rare condition affecting about 1-2% of pregnancies, in which the amnion and chorion fetal membranes essentially "double back" on the fetal side around the edges of the placenta. After delivery, a circumvallate placenta has a thick ring of membranes on its fetal surface. Circumvallate placenta is a placental morphological abnormality associated with increased fetal morbidity and mortality due to the restricted availability of nutrients and oxygen to the developing fetus.

Tobacco smoking during pregnancy causes many detrimental effects on health and reproduction, in addition to the general health effects of tobacco. A number of studies have shown that tobacco use is a significant factor in miscarriages among pregnant smokers, and that it contributes to a number of other threats to the health of the foetus.

<span class="mw-page-title-main">Prenatal nutrition</span>

Prenatal nutrition addresses nutrient recommendations before and during pregnancy. Nutrition and weight management before and during pregnancy has a profound effect on the development of infants. This is a rather critical time for healthy development since infants rely heavily on maternal stores and nutrient for optimal growth and health outcome later in life.

Nutriepigenomics is the study of food nutrients and their effects on human health through epigenetic modifications. There is now considerable evidence that nutritional imbalances during gestation and lactation are linked to non-communicable diseases, such as obesity, cardiovascular disease, diabetes, hypertension, and cancer. If metabolic disturbances occur during critical time windows of development, the resulting epigenetic alterations can lead to permanent changes in tissue and organ structure or function and predispose individuals to disease.

<span class="mw-page-title-main">High-risk pregnancy</span> Medical condition

A high-risk pregnancy is one where the mother or the fetus has an increased risk of adverse outcomes compared to uncomplicated pregnancies. No concrete guidelines currently exist for distinguishing “high-risk” pregnancies from “low-risk” pregnancies; however, there are certain studied conditions that have been shown to put the mother or fetus at a higher risk of poor outcomes. These conditions can be classified into three main categories: health problems in the mother that occur before she becomes pregnant, health problems in the mother that occur during pregnancy, and certain health conditions with the fetus.

A pre-existing disease in pregnancy is a disease that is not directly caused by the pregnancy, in contrast to various complications of pregnancy, but which may become worse or be a potential risk to the pregnancy. A major component of this risk can result from necessary use of drugs in pregnancy to manage the disease.

Obstetric medicine, similar to maternal medicine, is a sub-specialty of general internal medicine and obstetrics that specializes in process of prevention, diagnosing, and treating medical disorders in with pregnant women. It is closely related to the specialty of maternal-fetal medicine, although obstetric medicine does not directly care for the fetus. The practice of obstetric medicine, or previously known as "obstetric intervention," primarily consisted of the extraction of the baby during instances of duress, such as obstructed labor or if the baby was positioned in breech.

The fetal origins hypothesis proposes that the period of gestation has significant impacts on the developmental health and wellbeing outcomes for an individual ranging from infancy to adulthood. The effects of fetal origin are marked by three characteristics: latency, wherein effects may not be apparent until much later in life; persistency, whereby conditions resulting from a fetal effect continue to exist for a given individual; and genetic programming, which describes the 'switching on' of a specific gene due to prenatal environment. Research in the areas of economics, epidemiology, and epigenetics offer support for the hypothesis.

Fetal programming, also known as prenatal programming, is the theory that environmental cues experienced during fetal development play a seminal role in determining health trajectories across the lifespan.

<span class="mw-page-title-main">Diabetic embryopathy</span> Medical condition

Diabetic embryopathy refers to congenital maldevelopments that are linked to maternal diabetes. Prenatal exposure to hyperglycemia can result in spontaneous abortions, perinatal mortality, and malformations. Type 1 and Type 2 diabetic pregnancies both increase the risk of diabetes induced teratogenicity. The rate of congenital malformations is similar in Type 1 and 2 mothers because of increased adiposity and the age of women with type 2 diabetes. Genetic predisposition and different environmental factors both play a significant role in the development of diabetic embryopathy. Metabolic dysfunction in pregnant mothers also increases the risk of fetal malformations.

References

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  2. 1 2 3 Boyles S (3 February 2006). "Obesity Increases Risks in Pregnancy – Moms and Babies Have More Problems". WebMD Health News.
  3. 1 2 Goodman A (10 February 2009). "Maternal Obesity Increases Risk for Congenital Anomalies". medscape.com.
  4. 1 2 3 Smith GC, Shah I, Pell JP, Crossley JA, Dobbie R (January 2007). "Maternal obesity in early pregnancy and risk of spontaneous and elective preterm deliveries: a retrospective cohort study". American Journal of Public Health. 97 (1): 157–62. doi:10.2105/AJPH.2005.074294. PMC   1716235 . PMID   17138924.
  5. ↑ Bayol SA, Simbi BH, Bertrand JA, Stickland NC (July 2008). "Offspring from mothers fed a 'junk food' diet in pregnancy and lactation exhibit exacerbated adiposity that is more pronounced in females". The Journal of Physiology. 586 (13): 3219–30. doi:10.1113/jphysiol.2008.153817. PMC   2538787 . PMID   18467362.
  6. ↑ "Early-onset paternal obesity linked to increased risk for liver disease in child". Thaindian News. Retrieved 2 December 2016.
  7. ↑ Konkel, Lindsey (30 May 2013). "7 Ways Pregnant Women affect babies". Livescience. Retrieved 27 January 2017.
  8. ↑ Chu SY, Kim SY, Schmid CH, Dietz PM, Callaghan WM, Lau J, Curtis KM (September 2007). "Maternal obesity and risk of cesarean delivery: a meta-analysis". Obesity Reviews. 8 (5): 385–94. doi:10.1111/j.1467-789X.2007.00397.x. PMID   17716296. S2CID   41480162.
  9. ↑ Ramsay JE, Ferrell WR, Crawford L, Wallace AM, Greer IA, Sattar N (September 2002). "Maternal obesity is associated with dysregulation of metabolic, vascular, and inflammatory pathways". The Journal of Clinical Endocrinology and Metabolism. 87 (9): 4231–7. doi: 10.1210/jc.2002-020311 . PMID   12213876.
  10. ↑ Huda SS, Brodie LE, Sattar N (April 2010). "Obesity in pregnancy: prevalence and metabolic consequences". Seminars in Fetal & Neonatal Medicine. 15 (2): 70–6. doi:10.1016/j.siny.2009.09.006. PMID   19896913.
  11. ↑ Challier JC, Basu S, Bintein T, Minium J, Hotmire K, Catalano PM, Hauguel-de Mouzon S (March 2008). "Obesity in pregnancy stimulates macrophage accumulation and inflammation in the placenta". Placenta. 29 (3): 274–81. doi:10.1016/j.placenta.2007.12.010. PMC   4284075 . PMID   18262644.
  12. ↑ "The Pregnant Mother: Exercise During Pregnancy". Ohio State University Medical Center. 2009. Archived from the original on 2009-04-04. Retrieved 2009-03-26.
  13. ↑ Weiss RE. "Pregnant Women Need More Exercise" . Retrieved 2 December 2016.
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