ROLE OF THE PRENATAL ENVIRONMENT IN THE DEVELOPMENT OF OBESITY

Establishing that prenatal life is a critical or sensitive period for the development of obesity may focus basic research and clinical preve ntion efforts on this period. This review summarizes evidence that the intrauterine environment influences the risk of later obesity and con siders the mechanisms by which this may occur. The association between birth weight and adult weight suggests that there are enduring effect s of the intrauterine environment on later obesity risk. We examine wh ether the maternal factors of diabetes, obesity, and pregnancy weight gain alter the intrauterine environment and thereby increase the risk of later obesity in the offspring. Of these maternal factors, evidence is strongest for the role of maternal diabetes. No single mechanism e xplains how these maternal factors could change the intrauterine envir onment to increase obesity risk. However, all potential mechanisms inv olve an altered transfer of metabolic substrates between mother and fe tus, which may influence the developing structure or function of the o rgans involved in energy metabolism.