Maternal obesity is a proven obesity risk factor for the offspring. The progressive trend of increasing obesity prevalence among pregnant women is alarming and suggests the need for further efforts in public health intervention for obesity control ( Maffeis C, 1994) The dyadic mother-infant relationship begins in the earliest stage of prenatal life and continues through infancy. Offspring of overweight and obese women are at increased risk to be born large-for-gestational age and become overweight or obese as children or adults.2 Risk relates to maternal preconceptual weight, weight gain, and maternal glucose metabolism during pregnancy and breastfeeding. Thus, focusing on the mother and infant as an inseparable and reciprocal dyad allows an integral approach to promoting optimal weight in mothers and their offspring (Taveras EM, 2009).
In newborn infant, the strongest predictor of later obesity is maternal preconceptual BMI (Oken E, 2008). The mother’s preconceptual weight status is a marker of both environmental and genetic risk for the child. Genetic traits from the family can influence obesity risk. Excess gestational weight gain is associated with risk for both the infant and the mother( Olson CM, 2008; Oken E, 2008). Excess gestational weight gain is associated with fetal macrosomia and increased risk for developing childhood obesity ( Oken E, 2008). Macrosomic infants are at increased risk of obesity in childhood and adulthood compared to normal birthweight infants.
Evidence from both animal and human studies indicates that maternal obesity increases the risk for the offspring in developing obesity and altering body composition in child- and adulthood and, additionally, it also has an impact on the offspring’s cardiometabolic health with dysregulation of metabolism including glucose/insulin homoeostasis, and development of hypertension and vascular dysfunction. Potential mechanisms include effects on the development and function of adipose tissue, pancreas, muscle, liver, the vasculature and the brain ( Amanda J Drake, 2010).
Fetal macrosomia in obese women is associated not only with an increase in the absolute size of the fetus, but also in a change in body composition ( Sewell MF, 2006; Hull HR, 2008) Sewell and coworkers found that the average fat mass of infants born to mothers with a normal BMI ( 25 kg/m2, on the other hand, had a mean fat mass of 416 g, or a body fat composition of 11.6%. Of note, the majority of this effect appears to be a result of weight gain during pregnancy. Indeed, prepregnancy BMI appears to account for only 6.6% of the observed variation in infantile fat mass and only 7.2% of body fat composition (Catalano PM, 2006)