Maternal, fetal and child health is influenced by the maternal environment

Maternal, fetal and child health is influenced by the maternal environment

A recent editorial published in the magazine BMC Medicine examined the existing literature for associations between maternal and offspring health outcomes and a broad range of maternal characteristics associated with pregnancy and postnatal phenotypes and complications.

Learn: Maternal factors during pregnancy that influence maternal, fetal and child outcomes. Photo credit: Marc Roura / Shutterstock

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A body of research indicates that the immediate and long-term health of offspring is influenced to a large extent by the genetic, nutritional, psychological and immunological characteristics of the maternal environment. In addition, pregnancy complications such as preterm birth and preeclampsia are shown to affect maternal cardiovascular health.

Studies have also examined correlations between maternal diet, maternal weight, and gestational diabetes mellitus with fetal adiposity and early childhood obesity. A comprehensive analysis of existing research will help understand the common mechanisms underlying differential maternal and fetal health outcomes.

Premature birth

The authors examined the underlying mechanisms of preterm birth and reviewed studies on potential biomarkers and risk factors for preterm birth, including polycystic ovary syndrome (PCOS).

One of the studies examined correlations between placental proteins and spontaneous preterm birth and found that maternal and fetal alpha-1-antitrypsin (AAT) messenger ribonucleic acid (mRNA) and protein levels were downregulated in preterm births. They also found that reduced AAT protein levels affected the extracellular matrix and actin cytoskeleton.

Another study from Brazil examined risk factors for preterm birth in the second pregnancy and correlations with preterm birth in the first pregnancy. Interestingly, the study found that preterm birth during the second pregnancy (the first pregnancy was carried to term) was associated with socioeconomic conditions such as overcrowding at home and ethnic and age-related factors, with multiracial, black and indigenous mothers and very young mothers (under 19 years of age) being at higher risk of preterm birth. Additionally, fewer prenatal visits, stress, smoking habits and socioeconomic deprivation were other risk factors identified by the study.

Premature birth has also been linked to PCOS. PCOS is a metabolic disorder characterized by ovarian cysts, androgen excess, and infrequent or absent menstruation, with a wide range of symptoms and is associated with metabolic diseases such as obesity and diabetes with advancing age.

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A study from the United Kingdom examined the association between PCOS and obstetric complications and found that women with PCOS were 11% more likely to have preterm birth. However, because the study did not adjust for pregnancy-related complications such as high blood pressure and gestational diabetes, which are characteristic of preterm birth and PCOS, the authors believe that these complications are more likely to cause preterm birth.

Environmental pollution

The editorial also examined studies that examined the effects of obesity, smoking and the in utero environment on fetal health. Obesity has serious consequences such as preeclampsia, gestational diabetes and cesarean section. Studies have also found that the offspring of obese women have a higher risk of obesity, cardiovascular disease and type 2 diabetes, largely due to non-genetic factors.

A mother-child cohort study reported that children of obese mothers deviated from healthy weight gain patterns in the first few months after birth and were at high risk of being overweight or obese by age five.

Another study from Singapore examined correlations between maternal and fetal lipid profiles during pregnancy and found that fetal lipid profiles have higher concentrations of lysophospholipids, indicating specific developmental needs. The study also identified lower levels of triacylglycerols, phospholipids and sphingomyelin in the lipid profiles of obese mothers, highlighting the importance of weight control during pregnancy. The shared obesity characteristics of mothers and children could also be influenced by diet and similar lifestyles.

Along with obesity, maternal smoking was a strong predictor of abnormal body mass index (BMI) in children during early growth. Surprisingly, a Swedish study that examined the risk of type 1 diabetes associated with maternal smoking found that maternal smoking was associated with a 22 percent reduction in the risk of type 1 diabetes in offspring. However, the mechanistic pathways that could explain this correlation remain to be investigated.

Several other studies have found links between maternal smoking and shorter telomere length, a biomarker of cellular aging and oxidative damage. Studies also showed links between smoking, telomere length and attention deficit hyperactivity disorder (ADHD).

Conclusions

In conclusion, the present editorial examined the association between pregnancy phenotypes and complications and long-term maternal and infant health. In addition, the authors discussed various studies that examined the influence of maternal obesity on early childhood obesity as well as risk factors and biomarkers associated with preterm birth.

Studies that examined the association of socioeconomic and demographic factors and PCOS with the risk of preterm birth were also discussed. Maternal smoking behavior has been found to be linked to short telomere length and possible ADHD development in children.

Reference:

• Muglia, LJ, Benhalima, K., Tong, S., & Ozanne, S. (2022). Mütterliche Faktoren während der Schwangerschaft, die das mütterliche, fetale und kindliche Outcome beeinflussen. BMC-Medizin, 20(1). https://doi.org/10.1186/s12916-022-02632-6, https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-022-02632-6

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