ESPE Abstracts

Maternal obesity is the most common metabolic disturbance in pregnancy affecting more than 1 in 5 women in some regions. Obesity has short term risks during pregnancy for both mother and child, with increasing evidence demonstrating that there are also longer term risks of these exposures in pregnancy impacting on health of the offspring across the lifespan. Consistent and increasing evidence demonstrates a range of adverse health outcomes for offspring born to mothers who are obese in pregnancy. This includes increased risk of obesity, metabolic syndrome, cardiovascular risk factors in childhood and death from cardiovascular disease in adulthood, as well as neurodevelopmental and neuro-psychiatric outcomes in childhood. Potential mechanisms will be discussed including the role of glucose/insulin resistance and dysregulation of the hypothalamic-pituitary-adrenal axis. Evidence from the literature reporting links between maternal obesity and diabetes and offspring outcomes will be reviewed including from data-linkage studies, experimental studies and mechanistic studies as well as our own data from follow up of children born to severely obese women (BMI>40) who were characterised in detail in pregnancy. Data from follow-up studies of offspring born to mothers who participated in intervention trials in pregnancy (diet/lifestyle, pharmacological and bariatric surgery) will also be presented. Disentangling the ‘in utero’ exposure from the ‘postnatal’ environment is challenging in human studies and further studies are needed to understand underlying mechanisms. With limited evidence that intervention trials in pregnancy lead to improved outcomes for the child, consideration needs to be given to pre-conception interventions. Ensuring women are healthy prior to pregnancy offers a major opportunity to optimise the health of the next and future generations.