母亲肥胖与子代肥胖关系的研究进展

doi:10.11852/zgetbjzz2025-0804

摘要/Abstract

摘要： 近年来,儿童肥胖患病率持续攀升,对人群健康构成严重威胁。妇幼健康是全民健康的基石,而生命早期作为与妇幼健康紧密关联的特殊时期,亦是儿童生长发育的机遇窗口期,对全生命周期健康管理至关重要。研究表明,母亲在妊娠前、妊娠期及产后的肥胖状态会显著增加子代肥胖风险,但不同时期的作用重点及发生发展机制仍不够清晰。本文综述了母亲不同生理阶段肥胖与子代肥胖的关联,深入探讨了遗传因素、代谢重编程等潜在影响机制,并总结了相关干预措施,强调妊娠前-妊娠期-产后全周期防控的重要性,旨在从生命早期源头深入解析肥胖成因并探索防控策略,对推动我国儿童肥胖防治、促进妇幼健康具有重要意义。

关键词: 母亲肥胖, 儿童肥胖, 母婴, 生命早期

Abstract: In recent years, the rising incidence of childhood obesity has become a significant public health challenge.Maternal and child health (MCH) is the cornerstone of public health for all. Early life, as a critical period closely linked to MCH, is also a window of opportunity for child growth and development, making it crucial for life-cycle health management.Research indicates that maternal obesity status before pregnancy, during pregnancy, and postpartum significantly increases the risk of offspring obesity. However, the specific impacts of these different periods and the underlying developmental mechanisms are not yet fully understood. This paper reviews the association between maternal obesity at different physiological stages and offspring obesity. It further explores potential mechanisms, such as genetic factors and metabolic reprogramming, and summarizes relevant interventions.Emphasizing the importance of full-cycle prevention and control spanning the preconception, pregnancy, and postpartum periods, this review aims to better understand and prevent early-life obesity. This is crucial for reducing the prevalence of childhood obesity and promoting maternal and child health in China.

Key words: maternal obesity, childhood obesity, mother and child, early life

中图分类号:

R179

周烨清, 刘兰, 傅君芬. 母亲肥胖与子代肥胖关系的研究进展[J]. 中国儿童保健杂志, 2026, 34(1): 96-100.

ZHOU Yeqing, LIU Lan, FU Junfen. Progress on the relationship linking maternal obesity to offspring obesity[J]. Chinese Journal of Child Health Care, 2026, 34(1): 96-100.

参考文献

[1] GBD 2021 Adolescent BMI Collaborators.Global, regional, and national prevalence of child and adolescent overweight and obesity, 1990-2021, with forecasts to 2050: A forecasting study for the Global Burden of Disease Study 2021[J]. Lancet, 2025, 405(10481): 785-812.
[2] Heslehurst N, Vieira R, Akhter Z, et al. The association between maternal body mass index and child obesity: A systematic review and meta-analysis[J]. PLoS Med, 2019, 16(6): e1002817.
[3] Gnoth C, Godehardt D, Godehardt E, et al. Time to pregnancy: Results of the German prospective study and impact on the management of infertility[J]. Hum Reprod (Oxford, England), 2003, 18(9): 1959-1966.
[4] Schummers L, Hutcheon JA, Bodnar LM, et al. Risk of adverse pregnancy outcomes by prepregnancy body mass index: A population-based study to inform prepregnancy weight loss counseling[J]. Obstet Gynecol, 2015, 125(1):133-143.
[5] Yoshida S, Kimura T, Noda M, et al. Association of maternal prepregnancy weight and early childhood weight with obesity in adolescence: A population-based longitudinal cohort study in Japan[J]. Pediatr Obes, 2020, 15(4): e12597.
[6] Leonard SA, Rasmussen KM, King JC, et al. Trajectories of maternal weight from before pregnancy through postpartum and associations with childhood obesity[J]. Am J Clin Nutr, 2017, 106(5): 1295-1301.
[7] Stephenson J, Heslehurst N, Hall J, et al. Before the beginning: Nutrition and lifestyle in the preconception period and its importance for future health[J]. Lancet, 2018, 391(10132):1830-1841.
[8] Kaisinger LR, Kentistou KA, Stankovic S, et al. Large-scale exome sequence analysis identifies sex- and age-specific determinants of obesity[J]. Cell Genom, 2023, 3(8):100362.
[9] Han L, Ren C, Li L, et al. Embryonic defects induced by maternal obesity in mice derive from Stella insufficiency in oocytes[J]. Nat Genet, 2018, 50(3): 432-442.
[10] Si J, Meir AY, Hong X, et al. Maternal pre-pregnancy BMI, offspring epigenome-wide DNA methylation, and childhood obesity: Findings from the Boston Birth Cohort[J]. BMC Med, 2023, 21(1): 317.
[11] Hu Z, Han L, Liu J, et al. Prenatal metabolomic profiles mediate the effect of maternal obesity on early childhood growth trajectories and obesity risk: The conditions affecting neurocognitive development and learning in early childhood (CANDLE) study[J]. Am J Clin Nutr, 2022, 116(5): 1343-1353.
[12] Rasmussen KM, Yaktine AL, Institute of medicine (U.S.). Weight gain during pregnancy: Reexamining the guidelines[M]. Washington DC: National Academies Press, 2009.
[13] 国家卫生健康委员会. 妊娠期妇女体重增长推荐值标准[EB/OL].(2022-07-28) [2025-10-01]. http://www.nhc.gov.cn/fzs/s7848/202208/2c1c388fcd0c47c58630e5f971ebb468/files/3e00de62d92749fbbe749427a5ab75ef.pdf.
[14] Österroos A, Lindström L, Wikman P, et al. Maternal body mass index, gestational weight gain, and early childhood growth: A register-based cohort study[J]. Acta Obstet Gynecol Scand, 2024, 103(11): 2171-2182.
[15] Wrotniak BH, Shults J, Butts S, et al. Gestational weight gain and risk of overweight in the offspring at age 7 y in a multicenter, multiethnic cohort study 1-3[J]. Am J Clin Nutr, 2018, 87(6):1818-1824.
[16] 杨天,刘晟骅,胡梦博,等.母代肥胖对子代的影响及其机制的研究进展[J]. 复旦学报(医学版), 2016, 43(6): 738-744.
Yang T, Liu SH, Hu MB, et al. Research progress in the mechanisms of influence from maternal obesity to offspring[J]. Fudan Univ J Med Sci, 2016, 43(6): 738-744.(in Chinese)
[17] Gillman MW. Gestational weight gain: Now and the future[J]. Circulation, 2012, 125(11): 1339-1340.
[18] Parisi F, Milazzo R, Savasi VM, et al. Maternal low-grade chronic inflammation and intrauterine programming of health and disease[J]. Int J Mol Sci, 2021, 22(4): 1732.
[19] Wu YL, Lin ZJ, Li CC, et al. Epigenetic regulation in metabolic diseases: Mechanisms and advances in clinical study[J]. Signal Transduct Target Ther, 2023, 8(1): 98.
[20] Brion MJA, Ness AR, Rogers I, et al. Maternal macronutrient and energy intakes in pregnancy and offspring intake at 10 y: Exploring parental comparisons and prenatal effects[J]. Am J Clin Nutr, 2010, 91(3): 748-756.
[21] Gaillard R. Maternal obesity during pregnancy and cardiovascular development and disease in the offspring[J]. Eur J Epidemiol, 2015, 30(11): 1141-1152.
[22] Godfrey KM, Reynolds RM, Prescott SL, et al. Influence of maternal obesity on the long-term health of offspring[J]. Lancet Diabetes Endocrinol, 2017, 5(1): 53-64.
[23] Rooney BL, Schauberger CW. Excess pregnancy weight gain and long-term obesity: One decade later[J]. Obstet Gynecol, 2002, 100(2): 245-252.
[24] Nohr EA, Vaeth M, Baker JL, et al. Combined associations of prepregnancy body mass index and gestational weight gain with the outcome of pregnancy[J]. Am J Clin Nutr, 2008, 87(6): 1750-1759.
[25] Robinson CA, Cohen AK, Rehkopf DH, et al. Pregnancy and post-delivery maternal weight changes and overweight in preschool children[J]. Prev Med, 2014, 60: 77-82.
[26] Kramer MS, Kakuma R. Optimal duration of exclusive breastfeeding[J]. Cochrane Database Syst Rev, 2012, 2012(8): CD003517
[27] Turcksin R, Bel S, Galjaard S, et al. Maternal obesity and breastfeeding intention, initiation, intensity and duration: A systematic review[J]. Matern Child Nutr, 2014, 10(2): 166-183.
[28] Pena-Leon V, Folgueira C, Barja-Fernández S, et al. Prolonged breastfeeding protects from obesity by hypothalamic action of hepatic FGF21[J]. Nat Metab, 2022, 4(7): 901-917.
[29] Forbes JD, Azad MB, Vehling L, et al. Association of exposure to formula in the hospital and subsequent infant feeding practices with gut microbiota and risk of overweight in the first year of life[J]. JAMA Pediatr, 2018, 172(7): e181161.
[30] Isganaitis E, Venditti S, Matthews TJ, et al. Maternal obesity and the human milk metabolome: Associations with infant body composition and postnatal weight gain[J]. Am J Clin Nutr, 2019,110(1):111-120.
[31] Saben JL, Sims CR, Piccolo BD, et al. Maternal adiposity alters the human milk metabolome: Associations between nonglucose monosaccharides and infant adiposity[J]. Am J Clin Nutr, 2020, 112(5): 1228-1239.
[32] Hughes SO, Power TG, O'Connor TM, et al. Maternal feeding style and child weight status among Hispanic families with low-income levels: A longitudinal study of the direction of effects[J]. Int J Behav Nutr Phys Act, 2021, 18(1): 30.
[33] Lena Sagi-DaiN, Obesity in pregnancy: ACOG practice bulletin, Number 230[J].Obstet Gynecol, 2021, 138(3):489.
[34] Johansson K, Bodnar LM, Stephansson O, et al. Safety of low weight gain or weight loss in pregnancies with class 1, 2, and 3 obesity: A population-based cohort study[J]. Lancet, 2024, 403(10435): 1472-1481.
[35] Simon A, Pratt M, Hutton B, et al. Guidelines for the management of pregnant women with obesity: A systematic review[J]. Obes Rev, 2020, 21(3): e12972.
[36] Han L, Wang H, Li L, et al. Melatonin protects against maternal obesity-associated oxidative stress and meiotic defects in oocytes via the SIRT3-SOD2-dependent pathway[J]. J Pineal Res, 2017, 63(3).
[37] Lin Y, Wu J, Zhuo Y, et al. Effects of maternal methyl donor intake during pregnancy on ileum methylation and function in an intrauterine growth restriction pig model[J]. J Anim Sci Biotechnol, 2024, 15(1): 19.
[38] Moholdt T, Ashby ER, Tømmerdal KH, et al. Randomised controlled trial of exercise training during lactation on breast milk composition in breastfeeding people with overweight/obesity: A study protocol for the MILKSHAKE trial[J]. BMJ Open Sport Exerc Med, 2023, 9(4): e001751.