Influence of maternal obesity on the long-term health of offspring.
Influence of maternal obesity on the long-term health of offspring.
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母亲肥胖对后代长期健康的影响。
DOI：
10.1016/s2213-8587(16)30107-3
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发表时间：
2017-01
期刊：
影响因子：
--
通讯作者：
Broekman BF
中科院分区：
文献类型：
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作者：
Godfrey KM;Reynolds RM;Prescott SL;Nyirenda M;Jaddoe VW;Eriksson JG;Broekman BF
除了对妊娠并发症的直接影响外，越来越多的证据表明，母亲肥胖是儿童期和成年后后代健康的主要决定因素。观察性研究提供的证据表明，母亲肥胖对后代患肥胖症、冠心病、中风、2型糖尿病和哮喘的风险有影响。母亲肥胖还可能导致后代认知能力较差，患神经发育障碍（包括脑瘫）的风险增加。初步证据表明，免疫和传染病相关的结果的潜在影响。来自实验研究的见解支持母体肥胖对后代结果的因果影响，至少部分通过表观遗传过程的变化（包括DNA甲基化的改变）以及可能通过肠道微生物组的改变来介导。虽然肥胖妇女在怀孕前减肥的后代患肥胖症的风险降低，但迄今为止，很少有对照干预研究逆转了母亲的肥胖症，并检查了对后代的影响。孕产妇肥胖的长期影响可能具有深远的公共卫生影响，并表明迫切需要研究因果关系，潜在机制和有效的干预措施，以扭转育龄妇女肥胖的流行，并减轻其对后代的影响。
Alongside its immediate implications for pregnancy complications, increasing evidence implicates maternal obesity as a major determinant of health in the offspring during childhood and later adult life. Observational studies provide evidence for effects of maternal obesity on the offspring’s risks of obesity, coronary heart disease, stroke, type 2 diabetes and asthma. Maternal obesity may also lead to poorer cognitive performance in the offspring and an increased risk of neurodevelopmental disorders including cerebral palsy. Preliminary evidence suggests potential implications for immune and infectious disease related outcomes. Insights from experimental studies support causal effects of maternal obesity on offspring outcomes, mediated at least in part through changes in epigenetic processes including alternations in DNA methylation, and perhaps through alterations in the gut microbiome. Although the offspring of obese women who lose weight prior to pregnancy have a reduced risk of obesity, to date few controlled intervention studies have reversed maternal obesity and examined the consequences for the offspring. The long term effects of maternal obesity may have profound public health implications and indicate the urgency of studies on causality, underlying mechanisms and effective interventions to reverse the epidemic of obesity in women of child-bearing age and to mitigate its consequences for the offspring.