Maternal obesity in pregnancy impacts offspring cardiometabolic health: Systematic review and meta‐analysis of animal studies

Abstract

SummaryObesity before and during pregnancy leads to reduced offspring cardiometabolic health. Here, we systematically reviewed animal experimental evidence of maternal obesity before and during pregnancy and offspring anthropometry and cardiometabolic health. We systematically searched Embase and Medline from inception until January 2018. Eligible publications compared offspring of mothers with obesity to mothers with a normal weight. We performed meta‐analyses and subgroup analyses. We also examined methodological quality and publication bias. We screened 2543 publications and included 145 publications (N = 21 048 animals, five species). Essential methodological details were not reported in the majority of studies. We found evidence of publication bias for birth weight. Offspring of mothers with obesity had higher body weight (standardized mean difference (SMD) 0.76 [95% CI 0.60;0.93]), fat percentage (0.99 [0.64;1.35]), systolic blood pressure (1.33 [0.75;1.91]), triglycerides (0.64 [0.42;0.86], total cholesterol (0.46 [0.18;0.73]), glucose level (0.43 [0.24;0.63]), and insulin level (0.81 [0.61;1.02]) than offspring of control mothers, but similar birth weight. Sex, age, or species did not influence the effect of maternal obesity on offspring's cardiometabolic health. Obesity before and during pregnancy reduces offspring cardiometabolic health in animals. Future intervention studies should investigate whether reducing obesity prior to conception could prevent these detrimental programming effects and improve cardiometabolic health of future generations.

Adiposity and cardiovascular outcomes in three‐year‐old children of participants inUPBEAT, anRCTof a complex intervention in pregnant women with obesity

“…Resting pulse rate in children has also been reported to be inversely related to physical activity, 33 but this is an unlikely explanation for the difference in pulse rates observed between intervention arms in this study, as there was no association with parent‐reported child activity and sedentary time and resting pulse rate. An association between maternal obesity and offspring cardiometabolic dysfunction is widely reported in experimental animals 13‐16,34 . Rodent maternal obesity has been related to a sustained increase in offspring central sympathetic activity at the level of the hypothalamic neuronal pathways involved in peripheral autonomic regulation.…”

“…Although there are many reports of the consequences of maternal obesity on offspring health from animal 15 and cohort studies 7 very few have addressed the influence of an antenatal intervention beyond infancy 21 . The only study of an antenatal diet and physical activity intervention in women with obesity, which was effective at reducing GWG, reported no effect on offspring body composition at 2.8 years of age (n = 254) 41 .…”

“…Epidemiological observations from mother‐child cohorts have also reported associations between maternal obesity and cardiovascular morbidity and mortality rates in their children 11,12 . The inference of in utero effects of maternal obesity on offspring cardiovascular function is supported by animal models; numerous studies in experimental animals, reported by ourselves 13,14 and others, 15 have described a relationship between pre‐pregnancy maternal obesity and offspring cardiovascular dysfunction, including heart rate variability, enhanced cardiovascular response to stress, hypertension and higher circulating atherogenic lipids, 16‐18 observations which have been reported consistently across species.…”

Maternal High-Fat–High-Carbohydrate Diet-Induced Obesity Is Associated with Increased Appetite in Peripubertal Male but Not Female C57Bl/6J Mice

“…Specifically, outcomes from this study are clinically relevant to 2/3 of women entering the reproductive age as overweight or obese without diabetes, in the United States [ 37 , 38 ]. This population is overrepresented in obstetrics and is understudied [ 2 , 39 , 40 , 41 , 42 ].…”

A primer on ageing studies in mice: Considerations, opportunities and limitations

“…Careful breeding structures need to be employed as diet and age of the breeders can have an impact on subsequent generations [53][54][55]. Obesity in dams can affect the metabolic status of their offspring [56,57] and the age of breeding males can have effects on behavioural phenotypes in the offspring [58]. It is also essential that both sexes are studied as there are clear differences in the effects of interventions and the effects of ageing.…”