The Impact of Maternal Obesity and Weight Loss During the Periconceptional Period on Offspring Metabolism

Abstract

The current global obesity epidemic has resulted in more women entering pregnancy with a body mass index in the overweight and obese range. It has been shown that offspring of obese women are at increased risk of obesity and type 2 diabetes in childhood and adult life, thus giving rise to an `intergenerational cycle' of metabolic dysfunction. Importantly, studies in recent years have highlighted that the oocyte and/or early pre-implantation embryo is particularly vulnerable to the effects of maternal obesity resulting in long-lasting endocrine and metabolic effects for the offspring. Investigations into the molecular mechanisms underlying the programming of obesity and insulin resistance in liver, muscle and adipose tissue have highlighted the role of epigenetic changes within these tissues, which are recruited within the developing embryo and/or fetus. The periconceptional period is also an important period for intervention where dietary intervention in overweight/obese women is relatively more feasible. While dieting before pregnancy may have metabolic benefits for the offspring, there are however also metabolic and endocrine costs for the offspring. Thus, we need a better evidence base for the development of dietary interventions in obese women before pregnancy and around the time of conception to maximise the metabolic benefits and minimise the metabolic costs for the next generation.