Maternal obesity mediated predisposition to respiratory complications at birth and in later life: understanding the implications of the obesogenic intrauterine environment

Paediatr Respir Rev. 2017 Jan;21:11-18. doi: 10.1016/j.prrv.2016.10.003. Epub 2016 Oct 11.

Abstract

More women than not are entering pregnancy either overweight or obese. This presents a significant health care burden with respect to maternal morbidities and offspring complications at birth and in later life. In recent years it has also become clear that maternal obesity is an even greater global health problem than anticipated, because the effects are not limited to the mother but are also programmed in the fetus, known as the 'intergenerational cycle of obestiy'. Despite a large body of epidemiological evidence reporting outcomes of obese pregnancies, including offspring respiratory complications, much less is known about the molecular effects of maternal obesity on fetal lung development. This review focuses on the influence of altered substrate supply associated with the obesogenic intrauterine environment on fetal lung development. Understanding the molecular mechanisms contributing to altered fetal lung development will lead to improved respiratory outcomes for offspring at birth and in later life.

Keywords: Maternal obesity; developmental programming; fatty acid metabolism; fetal lung; gestational diabetes; metabolic syndrome; overnutrition; pulmonary surfactant; respiratory complications.

Publication types

  • Review

MeSH terms

  • Asthma / epidemiology
  • Asthma / metabolism
  • Bronchopulmonary Dysplasia / epidemiology
  • Bronchopulmonary Dysplasia / metabolism
  • Child
  • Cytokines / metabolism
  • Diabetes, Gestational / epidemiology
  • Diabetes, Gestational / metabolism
  • Fatty Acids / metabolism
  • Female
  • Humans
  • Hydrocortisone / metabolism
  • Infant, Newborn
  • Lung / embryology*
  • Metabolic Syndrome / metabolism
  • Obesity / epidemiology*
  • Obesity / metabolism
  • Pregnancy
  • Pregnancy Complications / epidemiology*
  • Pregnancy Complications / metabolism
  • Prenatal Exposure Delayed Effects / epidemiology*
  • Prenatal Exposure Delayed Effects / metabolism
  • Pulmonary Surfactants / metabolism
  • Respiratory Distress Syndrome, Newborn / epidemiology
  • Respiratory Distress Syndrome, Newborn / metabolism
  • Respiratory Tract Diseases / epidemiology*
  • Respiratory Tract Diseases / metabolism
  • Sleep Apnea Syndromes / epidemiology
  • Sleep Apnea Syndromes / metabolism
  • Transient Tachypnea of the Newborn / epidemiology
  • Transient Tachypnea of the Newborn / metabolism

Substances

  • Cytokines
  • Fatty Acids
  • Pulmonary Surfactants
  • Hydrocortisone