Summary

In addition to immediate implications for pregnancy complications, increasing evidence implicates maternal obesity as a major determinant of offspring health during childhood and later adult life. Observational studies provide evidence for effects of maternal obesity on her offspring's risks of obesity, coronary heart disease, stroke, type 2 diabetes, and asthma. Maternal obesity could also lead to poorer cognitive performance and 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, which are mediated at least partly through changes in epigenetic processes, such as alterations in DNA methylation, and perhaps through alterations in the gut microbiome. Although the offspring of obese women who lose weight before pregnancy have a reduced risk of obesity, few controlled intervention studies have been done in which maternal obesity is reversed and the consequences for offspring have been examined. Because the long-term effects of maternal obesity could have profound public health implications, there is an urgent need for studies on causality, underlying mechanisms, and effective interventions to reverse the epidemic of obesity in women of childbearing age and to mitigate consequences for offspring.

The Lancet Diabetes & Endocrinology home. Opens in new tab

Get full text access

Log in, subscribe or purchase for full access.

References

1.

Norman, JE ∙ Reynolds, RM

The consequences of obesity and excess weight gain in pregnancy

Proc Nutr Soc. 2011; 70:450-456

2.

Drake, AJ ∙ Reynolds, RM

Impact of maternal obesity on offspring obesity and cardiometabolic disease risk

Reproduction. 2010; 140:387-398

3.

Heslehurst, N ∙ Rankin, J ∙ Wilkinson, J ∙ et al.

A nationally representative study of maternal obesity in England, UK: trends in incidence and demographic inequalities in 619 323 births, 1989–2007

Int J Obes (Lond). 2010; 34:420-428

4.

Patel, N ∙ Pasupathy, D ∙ Poston, L

Determining the consequences of maternal obesity on offspring health

Exp Physiol. 2015; 100:1421-1428

5.

Nelson, SM ∙ Matthews, P ∙ Poston, L

Maternal metabolism and obesity: modifiable determinants of pregnancy outcome

Hum Reprod Update. 2010; 16:255-275

6.

Stirrat, LI ∙ O'Reilly, JR ∙ Barr, SM ∙ et al.

Decreased maternal hypothalamic–pituitary–adrenal axis activity in very severely obese pregnancy: Associations with birthweight and gestation at delivery

Psychoneuroendocrinology. 2016; 63:135-143

7.

Lewis, RM ∙ Demmelmair, H ∙ Gaillard, R ∙ et al.

The placental exposome: placental determinants of fetal adiposity and postnatal body composition

Ann Nutr Metab. 2013; 63:208-215

8.

Gaillard, R ∙ Felix, JF ∙ Duijts, L ∙ et al.

Childhood consequences of maternal obesity and excessive weight gain during pregnancy

Acta Obstet Gynecol Scand. 2014; 93:1085-1089

9.

Gaillard, R

Maternal obesity during pregnancy and cardiovascular development and disease in the offspring

Eur J Epidemiol. 2015; 30:1141-1152

10.

Yu, Z ∙ Han, S ∙ Zhu, J ∙ et al.

Pre-pregnancy body mass index in relation to infant birth weight and offspring overweight/obesity: a systematic review and meta-analysis

PLoS One. 2013; 8:e61627

11.

Tie, HT ∙ Xia, YY ∙ Zeng, YS ∙ et al.

Risk of childhood overweight or obesity associated with excessive weight gain during pregnancy: a meta-analysis

Arch Gynecol Obstet. 2014; 289:247-257

12.

Gaillard, R ∙ Steegers, EA ∙ Duijts, L ∙ et al.

Childhood cardiometabolic outcomes of maternal obesity during pregnancy: the Generation R Study

Hypertension. 2014; 63:683-691

13.

Catalano, PM ∙ Farrell, K ∙ Thomas, A ∙ et al.

Perinatal risk factors for childhood obesity and metabolic dysregulation

Am J Clin Nutr. 2009; 90:1303-1313

14.

Lawlor, DA ∙ Timpson, NJ ∙ Harbord, RM ∙ et al.

Exploring the developmental overnutrition hypothesis using parental–offspring associations and FTO as an instrumental variable

PLoS Med. 2008; 5:e33

15.

Robinson, SM ∙ Crozier, SR ∙ Harvey, NC ∙ et al.

Modifiable early-life risk factors for childhood adiposity and overweight: an analysis of their combined impact and potential for prevention

Am J Clin Nutr. 2015; 101:368-375

16.

Gaillard, R ∙ Steegers, EA ∙ Franco, OH ∙ et al.

Maternal weight gain in different periods of pregnancy and childhood cardio-metabolic outcomes. The Generation R Study

Int J Obes. 2015; 39:677-685

17.

Fraser, A ∙ Tilling, K ∙ Macdonald-Wallis, C ∙ et al.

Association of maternal weight gain in pregnancy with offspring obesity and metabolic and vascular traits in childhood

Circulation. 2010; 121:2557-2564

18.

Crozier, SR ∙ Inskip, HM ∙ Godfrey, KM ∙ et al.

Weight gain in pregnancy and childhood body composition: findings from the Southampton Women's Survey

Am J Clin Nutr. 2010; 91:1745-1751

19.

Oken, E ∙ Rifas-Shiman, SL ∙ Field, AE ∙ et al.

Maternal gestational weight gain and offspring weight in adolescence

Obstet Gynecol. 2008; 112:999-1006

20.

Perng, W ∙ Gillman, MW ∙ Mantzoros, CS ∙ et al.

A prospective study of maternal prenatal weight and offspring cardiometabolic health in midchildhood

Ann Epidemiol. 2014; 24:793-800

21.

Oostvogels, AJ ∙ Stronks, K ∙ Roseboom, TJ ∙ et al.

Maternal prepregnancy BMI, offspring's early postnatal growth, and metabolic profile at age 5–6 years: the ABCD Study

J Clin Endocrinol Metab. 2014; 99:3845-3854

22.

Laitinen, J ∙ Jaaskelainen, A ∙ Hartikainen, AL ∙ et al.

Maternal weight gain during the first half of pregnancy and offspring obesity at 16 years: a prospective cohort study

BJOG. 2012; 119:716-723

23.

Hochner, H ∙ Friedlander, Y ∙ Calderon-Margalit, R ∙ et al.

Associations of maternal prepregnancy body mass index and gestational weight gain with adult offspring cardiometabolic risk factors: the Jerusalem Perinatal Family Follow-up Study

Circulation. 2012; 125:1381-1389

24.

Tequeanes, AL ∙ Gigante, DP ∙ Assuncao, MC ∙ et al.

Maternal anthropometry is associated with the body mass index and waist:height ratio of offspring at 23 years of age

J Nutr. 2009; 139:750-754

25.

Reynolds, RM ∙ Osmond, C ∙ Phillips, DIW ∙ et al.

Maternal BMI, parity and pregnancy weight gain: influences on offspring adiposity in young adulthood

J Clin Endocrinol Metab. 2010; 95:5365-5369

26.

Schack-Nielsen, L ∙ Michaelsen, KF ∙ Gamborg, M ∙ et al.

Gestational weight gain in relation to offspring body mass index and obesity from infancy through adulthood

Int J Obes. 2010; 34:67-74

27.

Hrolfsdottir, L ∙ Rytter, D ∙ Olsen, SF ∙ et al.

Gestational weight gain in normal weight women and offspring cardio-metabolic risk factors at 20 years of age

Int J Obes. 2015; 39:671-676

28.

Rooney, BL ∙ Mathiason, MA ∙ Schauberger, CW

Predictors of obesity in childhood, adolescence, and adulthood in a birth cohort

Matern Child Health J. 2011; 15:1166-1175

29.

Mamun, AA ∙ O'Callaghan, M ∙ Callaway, L ∙ et al.

Associations of gestational weight gain with offspring body mass index and blood pressure at 21 years of age: evidence from a birth cohort study

Circulation. 2009; 119:1720-1727

30.

Forsén, T ∙ Eriksson, JG ∙ Tuomilehto, J ∙ et al.

Mother's weight in pregnancy and coronary heart disease in a cohort of Finnish men: follow up study

BMJ. 1997; 315:837-840

31.

Eriksson, JG ∙ Sandboge, S ∙ Salonen, M ∙ et al.

Maternal weight in pregnancy and offspring body composition in late adulthood: findings from the Helsinki Birth Cohort Study (HBCS)

Ann Med. 2015; 47:94-99

32.

Reynolds, RM ∙ Allan, KM ∙ Raja, EA ∙ et al.

Maternal obesity during pregnancy and premature mortality from cardiovascular event in adult offspring: follow-up of 1 323 275 person years

BMJ. 2013; 347:f4539

33.

Eriksson, JG ∙ Sandboge, S ∙ Salonen, MK ∙ et al.

Long-term consequences of maternal overweight in pregnancy on offspring later health: findings from the Helsinki Birth Cohort Study

Ann Med. 2014; 46:434-438

34.

Clapp, 3rd, JF ∙ Seaward, BL ∙ Sleamaker, RH ∙ et al.

Maternal physiologic adaptations to early human pregnancy

Am J Obstet Gynecol. 1988; 159:1456-1460

35.

Dumas, O ∙ Varraso, R ∙ Gillman, MW ∙ et al.

Longitudinal study of maternal body mass index, gestational weight gain, and offspring asthma

Allergy. 2016;

published online March 10.

36.

Pike, KC ∙ Inskip, HM ∙ Robinson, S ∙ et al.

The relationship between maTernal adiposity and infant weight gain, and childhood wheeze and atopy

Thorax. 2013; 68:372-379

37.

Guerra, S ∙ Sartini, C ∙ Mendez, M ∙ et al.

Maternal prepregnancy obesity is an independent risk factor for frequent wheezing in infants by age 14 months

Paediatr Perinat Epidemiol. 2013; 27:100-108

38.

Harpsoe, MC ∙ Basit, S ∙ Bager, P ∙ et al.

Maternal obesity, gestational weight gain, and risk of asthma and atopic disease in offspring: a study within the Danish National Birth Cohort

J Allergy Clin Immunol. 2013; 131:1033-1040

39.

Watson, PE ∙ McDonald, BW

Subcutaneous body fat in pregnant New Zealand women: association with wheeze in their infants at 18 months

Matern Child Health J. 2013; 17:959-967

40.

Patel, SP ∙ Rodriguez, A ∙ Little, MP ∙ et al.

Associations between pre-pregnancy obesity and asthma symptoms in adolescents

J Epidemiol Community Health. 2012; 66:809-814

41.

Lowe, A ∙ Bråbäck, L ∙ Ekeus, C ∙ et al.

Maternal obesity during pregnancy as a risk for early-life asthma

J Allergy Clin Immunol. 2011; 128:1107-1109

42.

Scholtens, S ∙ Wijga, AH ∙ Brunekreef, B ∙ et al.

Maternal overweight before pregnancy and asthma in offspring followed for 8 years

Int J Obes (Lond). 2010; 34:606-613

43.

Kumar, R ∙ Story, RE ∙ Pongracic, JA ∙ et al.

Maternal pre-pregnancy obesity and recurrent wheezing in early childhood

Pediatr Allergy Immunol Pulmonol. 2010; 23:183-190

44.

Håberg, SE ∙ Stigum, H ∙ London, SJ ∙ et al.

Maternal obesity in pregnancy and respiratory health in early childhood

Paediatr Perinat Epidemiol. 2009; 23:352-362

45.

Reichman, NE ∙ Nepomnyaschy, L

Maternal pre-pregnancy obesity and diagnosis of asthma in offspring at age 3 years

Matern Child Health J. 2008; 12:725-733

46.

Forno, E ∙ Young, OM ∙ Kumar, R ∙ et al.

Maternal obesity in pregnancy, gestational weight gain, and risk of childhood asthma

Pediatrics. 2014; 134:e535-e546

47.

West, CE ∙ Renz, H ∙ Jenmalm, MC ∙ et al.

The gut microbiota and inflammatory noncommunicable diseases: associations and potentials for gut microbiota therapies

J Allergy Clin Immunol. 2015; 135:3-13

48.

Martino, D ∙ Prescott, SL

Epigenetics and prenatal influences on asthma and allergic airways disease

Chest. 2011; 139:640-647

49.

Gohir, W ∙ Ratcliffe, EM ∙ Sloboda, DM

Of the bugs that shape us: maternal obesity, the gut microbiome, and long-term disease risk

Pediatr Res. 2015; 77:196-204

50.

Thorburn, AN ∙ Macia, L ∙ Mackay, CR

Diet, metabolites, and “western-lifestyle” inflammatory diseases

Immunity. 2014; 40:833-842

51.

Thorburn, AN ∙ McKenzie, CI ∙ Shen, S ∙ et al.

Evidence that asthma is a developmental origin disease influenced by maternal diet and bacterial metabolites

Nat Commun. 2015; 6:7320

52.

Netting, MJ ∙ Middleton, PF ∙ Makrides, M

Does maternal diet during pregnancy and lactation affect outcomes in offspring? A systematic review of food-based approaches

Nutrition. 2014; 30:1225-1241

53.

Prescott, SL

Early-life environmental determinants of allergic diseases and the wider pandemic of inflammatory noncommunicable diseases

J Allergy Clin Immunol. 2013; 131:23-30

54.

Seidell, JC ∙ Halberstadt, J

The global burden of obesity and the challenges of prevention

Ann Nutr Metab. 2015; 66:7-12

55.

Acosta, CD ∙ Knight, M

Sepsis and maternal mortality

Curr Opin Obstet Gynecol. 2013; 2:109-116

56.

Odaka, Y ∙ Nakano, M ∙ Tanaka, T ∙ et al.

The influence of a high-fat dietary environment in the fetal period on postnatal metabolic and immune function

Obesity. 2010; 18:1688-1694

57.

Myles, IA ∙ Fontecilla, NM ∙ Janelsins, BM ∙ et al.

Parental dietary fat intake alters offspring microbiome and immunity

J Immunol. 2013; 191:3200-3209

58.

Wilson, RM ∙ Marshall, NE ∙ Jeske, DR ∙ et al.

Maternal obesity alters immune cells frequencies and responses in umbilical cord blood samples

Pediatr Allergy Immunol. 2015; 26:344-351

59.

Lisciandro, JG ∙ van den Biggelaar, AH

Neonatal immune function and inflammatory illnesses in later life: lessons to be learnt from the developing world?

Clin Exp Allergy. 2010; 40:1719-1731

60.

Thornton, CA ∙ Macfarlane, TV ∙ Holt, PG

The hygiene hypothesis revisited: role of materno-fetal interactions

Curr Allergy Asthma Rep. 2010; 10:444-452

61.

Almond, MH ∙ Edwards, MR ∙ Barclay, WS ∙ et al.

Obesity and susceptibility to severe outcomes following respiratory viral infection

Thorax. 2013; 68:684-686

62.

Nguyen, MU ∙ Wallace, MJ ∙ Pepe, S ∙ et al.

Perinatal inflammation: a common factor in the early origins of cardiovascular disease?

Clin Sci (Lond). 2015; 129:769-784

63.

Simane, AM ∙ Meier, HC

Association between prenatal exposure to maternal infection and offspring mood disorders: a review of the literature

Curr Probl Pediatr Adolesc Health Care. 2015; 45:325-364

64.

Jao, J ∙ Abrams, EJ

Metabolic complications of in utero maternal HIV and antiretroviral exposure in HIV-exposed infants

Pediatr Infect Dis J. 2014; 33:734-740

65.

Brion, MJ ∙ Zeegers, M ∙ Jaddoe, V ∙ et al.

Intrauterine effects of maternal prepregnancy overweight on child cognition and behavior in 2 cohorts

Pediatrics. 2011; 127:e202-e211

66.

Chen, Q ∙ Sjolander, A ∙ Langstrom, N ∙ et al.

Maternal pre-pregnancy body mass index and offspring attention deficit hyperactivity disorder: a population-based cohort study using a sibling-comparison design

Int J Epidemiol. 2014; 43:83-90

67.

Crisham Janik, MD ∙ Newman, TB ∙ Cheng, YW ∙ et al.

Maternal diagnosis of obesity and risk of cerebral palsy in the child

J Pediatr. 2013; 163:1307-1312

68.

Gardner, RM ∙ Lee, BK ∙ Magnusson, C ∙ et al.

Maternal body mass index during early pregnancy, gestational weight gain, and risk of autism spectrum disorders: results from a Swedish total population and discordant sibling study

Int J Epidemiol. 2015; 44:870-883

69.

Jo, H ∙ Schieve, LA ∙ Sharma, AJ ∙ et al.

Maternal prepregnancy body mass index and child psychosocial development at 6 years of age

Pediatrics. 2015; 135:e1198-e1209

70.

Li, YM ∙ Ou, JJ ∙ Liu, L ∙ et al.

Association between maternal obesity and autism spectrum disorder in offspring: a meta-analysis

J Autism Dev Disord. 2016; 46:95-102

71.

Pan, C ∙ Deroche, CB ∙ Mann, JR ∙ et al.

Is prepregnancy obesity associated with risk of cerebral palsy and epilepsy in children?

J Child Neurol. 2014; 29:NP196-NP201

72.

Rodriguez, A

Maternal pre-pregnancy obesity and risk for inattention and negative emotionality in children

J Child Psychol Psychiatry. 2010; 51:134-143

73.

Basatemur, E ∙ Gardiner, J ∙ Williams, C ∙ et al.

Maternal prepregnancy BMI and child cognition: a longitudinal cohort study

Pediatrics. 2013; 131:56-63

74.

Gage, SH ∙ Lawlor, DA ∙ Tilling, K ∙ et al.

Associations of maternal weight gain in pregnancy with offspring cognition in childhood and adolescence: findings from the Avon Longitudinal Study of Parents and Children

Am J Epidemiol. 2013; 177:402-410

75.

Mehta, SH ∙ Kerver, JM ∙ Sokol, RJ ∙ et al.

The association between maternal obesity and neurodevelopmental outcomes of offspring

J Pediatr. 2014; 165:891-896

76.

Torres-Espinola, FJ ∙ Berglund, SK ∙ et al.

Maternal obesity, overweight and gestational diabetes affect the offspring neurodevelopment at 6 and 18 months of age—a follow up from the PREOBE cohort

PLoS One. 2015; 10:e0133010

77.

Khandaker, GM ∙ Dibben, CR ∙ Jones, PB

Does maternal body mass index during pregnancy influence risk of schizophrenia in the adult offspring?

Obes Rev. 2012; 13:518-527

78.

Rivera, HM ∙ Christiansen, KJ ∙ Sullivan, EL

The role of maternal obesity in the risk of neuropsychiatric disorders

Front Neurosci. 2015; 9:194

79.

Sullivan, EL ∙ Nousen, EK ∙ Chamlou, KA

Maternal high fat diet consumption during the perinatal period programs offspring behavior

Physiol Behav. 2014; 123:236-242

80.

Kang, SS ∙ Kurti, A ∙ Fair, DA ∙ et al.

Dietary intervention rescues maternal obesity induced behavior deficits and neuroinflammation in offspring

J Neuroinflammation. 2014; 11:156

81.

Lane, M ∙ Zander-Fox, DL ∙ Robker, RL ∙ et al.

Peri-conception parental obesity, reproductive health, and transgenerational impacts

Trends Endocrinol Metab. 2015; 26:84-90

82.

Godfrey, KM ∙ Costello, PM ∙ Lillycrop, KA

The developmental environment, epigenetic biomarkers and long-term health

J Dev Orig Health Dis. 2015; 6:399-406

83.

McPherson, NO ∙ Owens, JA ∙ Fullston, T ∙ et al.

Preconception diet or exercise intervention in obese fathers normalizes sperm microRNA profile and metabolic syndrome in female offspring

Am J Physiol Endocrinol Metab. 2015; 308:E805-E821

84.

Michels, KB ∙ Harris, HR ∙ Barault, L

Birthweight, maternal weight trajectories and global DNA methylation of LINE-1 repetitive elements

PLoS One. 2011; 6:e25254

85.

Herbstman, JB ∙ Wang, S ∙ Perera, FP ∙ et al.

Predictors and consequences of global DNA methylation in cord blood and at three years

PLoS One. 2013; 8:e72824

86.

Morales, E ∙ Groom, A ∙ Lawlor, DA ∙ et al.

DNA methylation signatures in cord blood associated with maternal gestational weight gain: results from the ALSPAC cohort

BMC Res Notes. 2014; 7:278

87.

Liu, X ∙ Chen, Q ∙ Tsai, H-J ∙ et al.

Maternal preconception body mass index and offspring cord blood DNA methylation: exploration of early life origins of disease

Environ Mol Mutagen. 2014; 55:223-230

88.

Sharp, GC ∙ Lawlor, DA ∙ Richmond, RC ∙ et al.

Maternal pre-pregnancy BMI and gestational weight gain, offspring DNA methylation and later offspring adiposity: findings from the Avon Longitudinal Study of Parents and Children

Int J Epidemiol. 2015; 44:1288-1304

89.

Guénard, F ∙ Tchernof, A ∙ Deshaies, Y ∙ et al.

Methylation and expression of immune and inflammatory genes in the offspring of bariatric bypass surgery patients

J Obes. 2013; 492:170

90.

Gemma, C ∙ Sookoian, S ∙ Alvariñas, J ∙ et al.

Maternal pregestational BMI is associated with methylation of the PPARGC1A promoter in newborns

Obesity (Silver Spring). 2009; 17:1032-1039

91.

Hoyo, C ∙ Fortner, K ∙ Murtha, AP ∙ et al.

Association of cord blood methylation fractions at imprinted insulin-like growth factor 2 (IGF2), plasma IGF2, and birth weight

Cancer Causes Control. 2012; 23:635-645

92.

Soubry, A ∙ Schildkraut, JM ∙ Murtha, A ∙ et al.

Paternal obesity is associated with IGF2 hypomethylation in newborns: results from a Newborn Epigenetics Study (NEST) cohort

BMC Med. 2013; 6:11-29

93.

Soubry, A ∙ Murphy, SK ∙ Wang, F ∙ et al.

Newborns of obese parents have altered DNA methylation patterns at imprinted genes

Int J Obes (Lond). 2015; 39:650-657

94.

Burris, HH ∙ Baccarelli, AA ∙ Byun, HM ∙ et al.

Offspring DNA methylation of the aryl-hydrocarbon receptor repressor gene is associated with maternal BMI, gestational age, and birth weight

Epigenetics. 2015; 10:913-921

95.

Guénard, F ∙ Tchernof, A ∙ Deshaies, Y ∙ et al.

Methylation and expression of immune and inflammatory genes in the offspring of bariatric bypass surgery patients

J Obes. 2013; 2013:492170

96.

Allard, C ∙ Desgagné, V ∙ Patenaude, J ∙ et al.

Mendelian randomization supports causality between maternal hyperglycemia and epigenetic regulation of leptin gene in newborns

Epigenetics. 2015; 10:342-351

97.

Fisk, CM ∙ Crozier, SR ∙ Inskip, HM ∙ et al., Southampton Women's Survey Study Group

Influences on the quality of young children's diets: the importance of maternal food choices

Br J Nutr. 2011; 105:287-296

98.

Dogra, S ∙ Sakwinska, O ∙ Soh, S-E ∙ et al.

Rate of establishing the gut microbiota in infancy has consequences for future health

Gut Microbes. 2015; 6:321-325

99.

Tint, MT ∙ Fortier, MV ∙ Godfrey, KM ∙ et al.

Abdominal adipose tissue compartments vary with ethnicity in Asian neonates: Growing Up in Singapore Toward Healthy Outcomes birth cohort study

Am J Clin Nutr. 2016; 103:1311-1317

100.

Clarke-Harris, R ∙ Wilkin, TJ ∙ Hosking, J ∙ et al.

PGC1α promoter methylation in blood at 5–7 years predicts adiposity from 9 to 14 years (EarlyBird 50)

Diabetes. 2014; 63:2528-2537

101.

De Bustos, C ∙ Ramos, E ∙ Young, JM ∙ et al.

Tissue-specific variation in DNA methylation levels along human chromosome 1

Epigenetics Chromatin. 2009; 2:7

102.

Talens, RP ∙ Boomsma, DI ∙ Tobi, EW ∙ et al.

Variation, patterns, and temporal stability of DNA methylation: considerations for epigenetic epidemiology

FASEB J. 2010; 24:3135-3144

103.

Dogra, S ∙ Sakwinska, O ∙ Soh, SE ∙ et al.

Dynamics of infant gut microbiota are influenced by delivery mode and gestational duration and are associated with subsequent adiposity

MBio. 2015; 6:e02419-e02514

104.

Spencer, SJ

Perinatal nutrition programs neuroimmune function long-term: mechanisms and implications

Front Neurosci. 2013; 7:144

105.

Petra, AI ∙ Panagiotidou, S ∙ Hatziagelaki, E ∙ et al.

Gut-microbiota-brain axis and its effect on neuropsychiatric disorders with suspected immune dysregulation

Clin Ther. 2015; 37:984-995

106.

Piyasena, C ∙ Cartier, J ∙ Khulan, B ∙ et al.

Dynamics of DNA methylation at IGF2 in preterm and term infants during the first year of life: an observational study

Lancet. 2015; 385(suppl 1):S81

107.

Teh, AL ∙ Pan, H ∙ Chen, L ∙ et al.

The effect of genotype and in utero environment on interindividual variation in neonate DNA methylomes

Genome Res. 2014; 24:1064-1074

108.

Smit, J ∙ Cianflone, K ∙ Biron, S ∙ et al.

Effects of maternal surgical weight loss in mothers on intergenerational transmission of obesity

J Clin Endocrinol Metab. 2009; 94:4275-4283

109.

Forbes, S ∙ Barr, SM ∙ Reynolds, RM ∙ et al.

Convergence in insulin resistance between very severely obese and lean women at the end of pregnancy

Diabetologia. 2015; 58:2615-2696

110.

Flegal, KM ∙ Carroll, MD ∙ Kit, BK ∙ et al.

Prevalence of obesity and trends in the distribution of body mass index among US adults, 1999–2010

JAMA. 2012; 307:491-497