Effects of excessive weight gain during pregnancy on offspring health: a review
JI Wenhui1,2, CHANG Jinke1, LI Tao1
1. Graduate School of Inner Mongolia Medical University, Hohhot, Inner Mongolia 010107, China; 2. Maternal and Child Health Hospital of Inner Mongolia Autonomous Region, Hohhot, Inner Mongolia 010020, China
Abstract:Excessive gestational weight gain has already become a global clinical and public health problem that seriously affects maternal health. Excessive gestational weight gain not only increases the cesarean section rate and induces adverse pregnant outcomes, but also affects offspring development and health. This article reviews the effects of excessive weight gain during pregnancy on offspring health and its underlying mechanisms. Excessive gestational weight gain may increase the risk of obesity, cardiovascular diseases, infectious diseases of the respiratory tract, diabetes, polycystic ovary syndrome, mental or psychological illness among offspring, and the pathophysiological mechanisms include inflammatory response, intestinal flora dysbiosis and epigenetics theory. However, further studies are required to validate these hypotheses and to evaluate the effect of excessive weight gain at different gestational stages on offspring health, so as to provide insights into reasonable management of weight gain during pregnancy and improvements of offspring health.
冀文慧, 常进科, 李弢. 孕期增重过度对子代健康影响的研究进展[J]. 预防医学, 2023, 35(9): 774-777.
JI Wenhui, CHANG Jinke, LI Tao. Effects of excessive weight gain during pregnancy on offspring health: a review. Preventive Medicine, 2023, 35(9): 774-777.
[1] GOLDSTEIN R F,ABELL S K,RANASINHA S,et al.Association of gestational weight gain with maternal and infant outcomes:a systematic review and meta-analysis[J].JAMA,2017,317(21):2207-2225. [2] 毕烨,王杰,段一凡,等.2015年中国女性妊娠中晚期增重状况及影响因素[J].卫生研究,2022,51(3):392-396,416. [3] ROLLAND-CACHERA M F,AKROUT M,PENEAU S.Nutrient intakes in early life and risk of obesity[J/OL].Int J Environ Res Public Health,2016,13(6)[2023-07-16].https://doi.org/10.3390/ijerph13060564. [4] SANTOS MONTEIRO S,S SANTOS T,FONSECA L,et al.Inappropriate gestational weight gain impact on maternofetal outcomes in gestational diabetes[J].Ann Med,2023,55(1):207-214. [5] BARKER D J P.The fetal origins of adult disease[J].Fetal Matern Med Rev,1994,6(2):71-80. [6] 施长春. 宫内环境不良与生命早期糖脂代谢指标的前瞻性队列研究[D].杭州:浙江大学,2017. [7] GODFREY K M,REYNOLDS R M,PRESCOTT S L,et al.Influence of maternal obesity on the long-term health of offspring[J].Lancet Diabetes Endocrinol,2017,5(1):53-64. [8] 王玉梅. 中小学生肥胖流行现状及知信行综合干预效果评价研究[D].沈阳:中国医科大学,2021. [9] 张智玮,陈楹,全春霞,等.孕期膳食血糖负荷与孕期增重及胎儿体格发育的关系[J].卫生研究,2023,52(3):418-423. [10] 陈晓雯,胡文胜,朱旭红,等.孕前体质指数、孕期增重对巨大儿发生的影响[J].预防医学,2020,32(4):414–417. [11] 王国成,麻伟博.单胎孕妇孕期增重、血脂水平对妊娠结局、新生儿体成分的影响[J].中国计划生育学杂志,2023,31(2):460-465. [12] 陆雯昳. 孕早中晚期增重对5岁子代超重肥胖的影响[D].上海:上海交通大学,2019. [13] SCHACK-NIELSEN L,MICHAELSEN K F,GAMBORG M,et al.Gestational weight gain in relation to offspring body mass index and obesity from infancy through adulthood[J].Int J Obes(Lond),2010,34(1):67-74. [14] CHAN L L Y,SEBERT S P,HYATT M A,et al.Effect of maternal nutrient restriction from early to midgestation on cardiac function and metabolism after adolescent-onset obesity[J].Am J Physiol Regul Integr Comp Physiol,2009,296(5):1455-1463. [15] KISLAL S,SHOOK L L,EDLOW A G.Perinatal exposure to maternal obesity:lasting cardiometabolic impact on offspring[J].Prenatal diagnosis,2020,40(9):1109-1125. [16] GAILLARD R,STEEGERS E A P,FRANCO O H,et al.Maternal weight gain in different periods of pregnancy and childhood cardio-metabolic outcomes.The Generation R Study[J].Int J Obes(Lond),2015,39(4):677-685. [17] WANG J,DU B W,WU Y J,et al.Association of maternal gestational weight gain with left ventricle geometry and function in offspring at 4 years of age:a prospective birth cohort study[J/OL].Front Pediatr,2021,9[2023-07-16].https://doi.org/10.3389/fped.2021.722385. [18] EITMANN S,MATRAI P,NEMETH D,et al.Maternal overnutrition elevates offspring's blood pressure:a systematic review and meta-analysis[J].Paediatr Perinat Epidemiol,2022,36(2):276-287. [19] WIZNIA A.Pediatric asthma:a global epidemic[J/OL].Ann Glob Health,2019,85(1)[2023-07-16].https://doi.org/10.5334/aogh.2416. [20] FORNO E,YOUNG O M,KUMAR R,et al.Maternal obesity in pregnancy,gestational weight gain,and risk of childhood asthma[J].Pediatrics,2014,134(2):e535-e546. [21] DUMAS O,VARRASO R,GILLMAN M W,et al.Longitudinal study of maternal body mass index,gestational weight gain,and offspring asthma[J].Allergy,2016,71(9):1295-1304. [22] 周波. 从肠—肺轴出发探讨母亲肥胖对子代呼吸系统的影响及机制研究[D].北京:北京中医药大学,2021. [23] PERNG W,OKEN E,DABELEA D.Developmental overnutrition and obesity and type 2 diabetes in offspring[J].Diabetologia,2019,62:1779-1788. [24] AGARWAL P,BRAR N,MORRISEAU T S,et al.Gestational diabetes adversely affects pancreatic islet architecture and function in the male rat offspring[J].Endocrinology,2019,160(8):1907-1925. [25] DABELEA D,KNOWLER W C,PETTITT D J.Effect of diabetes in pregnancy on offspring:follow up research in the Pima Indians[J].J Matern Fetal Med,2000,9(1):83-88. [26] 陈志燕. 基于回顾性病例分析、前瞻性多中心随机队列研究及Meta分析研究雄激素水平对于女性不孕患者的妊娠结局的影响[D].北京:北京协和医学院,2022. [27] 古兰·托合提木拉提,叶尔努尔·吐苏甫汗,马玉兰,等.雌性母鼠高脂肪暴露对子代糖脂代谢、卵巢功能的影响及与多囊卵巢综合征发病的关系研究[J].中国现代医学杂志,2021,31(8):27-35. [28] CONTU L,HAWKES C A.A review of the impact of maternal obesity on the cognitive function and mental health of the offspring[J/OL].Int J Mol Sci,2017,18(5)[2023-07-16].https://doi.org/10.3390/ijms18051093. [29] SASAKI A,DE VEGA W C,ST-CYR S,et al.Perinatal high fat diet alters glucocorticoid signaling and anxiety behavior in adulthood[J].Neuroscience,2013,240:1-12. [30] GARDNER R M,LEE B K,MAGNUSSON C,et al.Maternal body mass index during early pregnancy,gestational weight gain,and risk of autism spectrum disorders:results from a Swedish total population and discordant sibling study[J].Int J Epidemiol,2015,44(3):870-883. [31] PUGH S J,HUTCHEON J A,RICHARDSON G A,et al.Gestational weight gain,prepregnancy body mass index and offspring attention deficit hyperactivity disorder symptoms and behaviour at age 10[J].BJOG,2016,123(13):2094-2103. [32] 陈静思. 孕期过度增重与血清炎性因子、糖脂代谢及围生结局的关系[D].唐山:华北理工大学,2020. [33] 王雅斐. 孕期增重过度对儿童社交-情绪发育影响的出生队列研究及炎症因子的作用[D].合肥:安徽医科大学,2020. [34] HARPSOE M C,BASIT S,BAGER P,et al.Maternal obesity,gestational weight gain,and risk of asthma and atopic disease in offspring:a study within the Danish National Birth Cohort[J].J Allergy Clin Immunol,2013,131(4):1033-1040. [35] HAN V X,PATEL S,JONES H F,et al.Maternal acute and chronic inflammation in pregnancy is associated with common neurodevelopmental disorders:a systematic review[J/OL].Transl Psychiatry,2021,11(1)[2023-07-16].https://doi.org/10.1038/s41398-021-01198-w. [36] LEE J,JANG J Y,KWON M S,et al.Mixture of two Lactobacillus plantarum strains modulates the gut microbiota structure and regulatory T cell response in diet induced obese mice[J/OL].Mol Nutr Food Res,2018,62(24)[2023-07-16].https://doi.org/10.1002/mnfr.201800329. [37] 刘慧. 不同孕前体质指数、孕期增重母婴肠道菌群差异研究[D].太原:山西医科大学,2021. [38] FERNANDEZ-TWINN D S,HJORT L,NOVAKOVIC B,et al.Intrauterine programming of obesity and type 2 diabetes[J].Diabetologia,2019,62:1789-1801. [39] KING S E,SKINNER M K.Epigenetic transgenerational inheritance of obesity susceptibility[J].Trends Endocrinol Metab,2020,31(7):478-494. [40] 汪晖,焦哲潇.孕期不良环境所致的子代多种疾病易感及其宫内编程机制[J].中国药理学与毒理学杂志,2017,31(1):12-27.