Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Review
  • Published:

Maternal pre-pregnancy obesity and childhood physical and cognitive development of children: a systematic review

Abstract

Objective:

Maternal obesity, usually associated with the adverse birth outcomes, has been a serious public health concern. Studies examining its effect on the physical and cognitive development of children have only recently emerged and the findings are inconsistent. This review aimed to systematically examine the role of maternal obesity on children’s physical and cognitive development using the available evidence.

Methods:

The CINAHL, EMBASE, PSYCINFO, PUBMED and SCOPUS databases were searched. Studies addressing children’s (12 years) physical and cognitive development as outcome and maternal pre-pregnancy body mass index as an exposure were included. Data were extracted and evaluated for quality by two independent reviewers.

Results:

A total of 17 articles were eligible for this systematic review; 10 of them were birth cohorts from the USA. Nine of the 14 studies supported an adverse association between maternal pre-pregnancy obesity and childhood cognitive development. A few studies also demonstrated a negative association between the maternal obesity and gross motor function in children (5 of 10), but not with fine motor function (none out of five studies). Whether the observed negative association between the maternal obesity and children’s cognitive and gross motor abilities is casual or due to residual confounding effects is unclear. The current evidence is based on a limited number of studies with heterogeneous measurement scales and obesity definition.

Conclusions:

From the available evidence, it seems that exposure to maternal pre-pregnancy obesity in the intrauterine environment has a detrimental effect on children’s cognitive development. However, evidence of the association between the maternal obesity and physical development of children is too scarce to offer a conclusion. More research work is required to delineate the intrauterine effect of the maternal obesity from the residual confounding effects.

This is a preview of subscription content, access via your institution

Access options

Rent or buy this article

Prices vary by article type

from$1.95

to$39.95

Prices may be subject to local taxes which are calculated during checkout

Figure 1

Similar content being viewed by others

References

  1. Development OfEC-oa. Obesity Update. 2014. available at http://www.oecd.org/health/Obesity-Update-2014.pdf.

  2. Kim SY, Dietz PM, England L, Morrow B, Callaghan WM . Trends in pre-pregnancy obesity in nine states, 1993-2003. Obesity (Silver Spring) 2007; 15: 986–993.

    Article  Google Scholar 

  3. McIntyre HD, Gibbons KS, Flenady VJ, Callaway LK . Overweight and obesity in Australian mothers: epidemic or endemic? Med J Aust 2012; 196: 184–188.

    Article  Google Scholar 

  4. Walls HL, Magliano DJ, Stevenson CE, Backholer K, Mannan HR, Shaw JE et al. Projected progression of the prevalence of obesity in Australia. Obesity (Silver Spring) 2012; 20: 872–878.

    Article  Google Scholar 

  5. Athukorala C, Rumbold AR, Willson KJ, Crowther CA . The risk of adverse pregnancy outcomes in women who are overweight or obese. BMC Pregnancy Childbirth 2010; 10: 56.

    Article  Google Scholar 

  6. Ovesen P, Rasmussen S, Kesmodel U . Effect of prepregnancy maternal overweight and obesity on pregnancy outcome. Obstet Gynecol 2011; 118: 305–312.

    Article  Google Scholar 

  7. Driul L, Cacciaguerra G, Citossi A, Martina MD, Peressini L, Marchesoni D . Prepregnancy body mass index and adverse pregnancy outcomes. Arch Gynecol Obstet 2008; 278: 23–26.

    Article  CAS  Google Scholar 

  8. Jain D, Khuteta R, Chaturvedi V, Khuteta S . Effect of body mass index on pregnancy outcomes in nulliparous women delivering singleton babies: observational study. J Obstet Gynaecol India 2012; 62: 429–431.

    Article  Google Scholar 

  9. World Health Organization. Global database on body mass index: BMI classification. 2016. available at http://appswhoint/bmi/indexjsp?introPage=intro_3html.

  10. Gaillard R . Maternal obesity during pregnancy and cardiovascular development and disease in the offspring. Eur J Epidemiol 2015; 30: 1141–1152.

    Article  Google Scholar 

  11. Van Lieshout RJ . Role of maternal adiposity prior to and during pregnancy in cognitive and psychiatric problems in offspring. Nutr Rev 2013; 71: S95–S101.

    Article  Google Scholar 

  12. Van Lieshout RJ, Taylor VH, Boyle MH . Pre-pregnancy and pregnancy obesity and neurodevelopmental outcomes in offspring: a systematic review. Obes Rev 2011; 12: e548–e559.

    Article  CAS  Google Scholar 

  13. Craig WY, Palomaki GE, Neveux LM, Haddow JE . Maternal body mass index during pregnancy and offspring neurocognitive development. Obstet Med 2013; 6: 20–25.

    Article  Google Scholar 

  14. Heikura U, Taanila A, Hartikainen AL, Olsen P, Linna SL, von Wendt L et al. Variations in prenatal sociodemographic factors associated with intellectual disability: a study of the 20-year interval between two birth cohorts in northern Finland. Am J Epidemiol 2008; 167: 169–177.

    Article  Google Scholar 

  15. Hinkle SN, Schieve LA, Stein AD, Swan DW, Ramakrishnan U, Sharma AJ . Associations between maternal prepregnancy body mass index and child neurodevelopment at 2 years of age. Int J Obes (Lond) 2012; 36: 1312–1319.

    Article  CAS  Google Scholar 

  16. Neggers YH, Goldenberg RL, Ramey SL, Cliver SP . Maternal prepregnancy body mass index and psychomotor development in children. Acta Obstet Gynecol Scand 2003; 82: 235–240.

    Article  Google Scholar 

  17. Tanda R, Salsberry P, Reagan P, Fang M . The impact of prepregnancy obesity on children's cognitive test scores. Matern Child Health J 2013; 17: 222–229.

    Article  Google Scholar 

  18. Brion MJ, Zeegers M, Jaddoe V, Verhulst F, Tiemeier H, Lawlor DA et al. Intrauterine effects of maternal prepregnancy overweight on child cognition and behavior in 2 cohorts. Pediatrics 2011; 127: e202–e211.

    Article  Google Scholar 

  19. Basatemur E, Julian Gardiner J, Williams C, Edward Melhuish E, Barnes J, Sutcliffe A . Maternal prepregnancy BMI and child cognition: a longitudinal cohort study. Pediatrics 2013; 131: 56–63.

    Article  Google Scholar 

  20. Bliddal M, Olsen J, Stovring H, Eriksen HL, Kesmodel US, Sorensen TI et al. Maternal pre-pregnancy BMI and intelligence quotient (IQ) in 5-year-old children: a cohort based study. PLoS ONE 2014; 9: e94498.

    Article  Google Scholar 

  21. Huang L, Yu X, Keim S, Li L, Zhang L, Zhang J . Maternal prepregnancy obesity and child neurodevelopment in the Collaborative Perinatal Project. Int J Epidemiol 2014; 43: 783–792.

    Article  Google Scholar 

  22. Casas M, Chatzi L, Carsin AE, Amiano P, Guxens M, Kogevinas M et al. Maternal pre-pregnancy overweight and obesity, and child neuropsychological development: two Southern European birth cohort studies. Int J Epidemiol 2013; 42: 506–517.

    Article  Google Scholar 

  23. Hinkle SN, Sharma AJ, Kim SY, Schieve LA . Maternal prepregnancy weight status and associations with children's development and disabilities at kindergarten. Int J Obes 2013; 37: 1344–1351.

    Article  CAS  Google Scholar 

  24. Polanska K, Muszynski P, Sobala W, Dziewirska E, Merecz-Kot D, Hanke W . Maternal lifestyle during pregnancy and child psychomotor development—Polish Mother and Child Cohort study. Early Hum Dev 2015; 91: 317–325.

    Article  Google Scholar 

  25. Reynolds LC, Inder TE, Neil JJ, Pineda RG, Rogers CE . Maternal obesity and increased risk for autism and developmental delay among very preterm infants. J Perinatol 2014; 34: 688–692.

    Article  CAS  Google Scholar 

  26. Wylie A, Sundaram R, Kus C, Ghassabian A, Yeung EH . Maternal prepregnancy obesity and achievement of infant motor developmental milestones in the upstate KIDS study. Obesity 2015; 23: 907–913.

    Article  Google Scholar 

  27. Rivera HM, Christiansen KJ, Sullivan EL . The role of maternal obesity in the risk of neuropsychiatric disorders. Front Neurosci 2015; 9: 194.

    Article  Google Scholar 

  28. Tuovinen S, Eriksson JG, Kajantie E, Raikkonen K . Maternal hypertensive pregnancy disorders and cognitive functioning of the offspring: a systematic review. J Am Soc Hypertens 2014; 8: 832–847 e1.

    Article  Google Scholar 

  29. Nomura Y, Marks DJ, Grossman B, Yoon M, Loudon H, Stone J et al. Exposure to gestational diabetes mellitus and low socioeconomic status: Effects on neurocognitive development and risk of attention-deficit/ hyperactivity disorder in offspring. Arch Pediatr Adolesc Med 2012; 166: 337–343.

    Article  Google Scholar 

  30. Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gotzsche PC, Ioannidis JP et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. PLoS Med 2009; 6: e1000100.

    Article  Google Scholar 

  31. Wells G, Shea B, O'Connell D, Peterson J, Welch V, Losos M et al The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses, 2014. Available at http://www.ohrica/programs/clinical_epidemiology/oxfordasp.

  32. Brubaker SG, Zork N, Pessel C, Gyamfi-Bannerman C, Ananth CV . Does maternal obesity affect offspring intelligence quotient (IQ)? Reprod Sci 2014; 21: 150A.

    Google Scholar 

  33. Chatzi L, Daraki V, Georgiou V, Koutra K, Kampouri M, Kyriklaki A et al. Maternal obesity, glucose levels in early pregnancy, and gestational diabetes in association with cognitive and psychomotor development at 4 years of age. Diabetologia 2014; 57: S72.

    Google Scholar 

  34. Paulson J, Mehta S, Sokol R, Chauhan S . Maternal obesity and long-term cognitive function of offspring. Am J Obstet Gynecol 2014; 210: S225.

    Article  Google Scholar 

  35. Zork N, Fuchs K, Brubaker S, Pessel C, Ananth C . Impact of maternal pre-pregnancy body mass index and gestational weight gain on offspring IQ. Am J Obstet Gynecol 2014; 210: S193.

    Article  Google Scholar 

  36. Eriksen HL, Kesmodel US, Underbjerg M, Kilburn TR, Bertrand J, Mortensen EL . Predictors of intelligence at the age of 5: family, pregnancy and birth characteristics, postnatal influences, and postnatal growth. PLoS ONE 2013; 8: e79200.

    Article  Google Scholar 

  37. Helderman JB, O'Shea TM, Kuban KC, Allred EN, Hecht JL, Dammann O et al. Antenatal antecedents of cognitive impairment at 24 months in extremely low gestational age newborns. Pediatrics 2012; 129: 494–502.

    Article  Google Scholar 

  38. Van Der Burg JW, Allred EN, Kuban K, O'Shea TM, Dammann O, Leviton A . Maternal obesity and development of the preterm newborn at 2 years. Acta Paediatr Int J Paediatr 2015; 104: 900–903.

    Article  Google Scholar 

  39. Islam MA . Maternal and Neonatal Predictors of Psychomotor and Physical Development of 5-Year-Old Children. ProQuest Information & Learning: USA, 2001.

    Google Scholar 

  40. Pugh SJ, Richardson GA, Hutcheon JA, Himes KP, Brooks MM, Day NL et al. Maternal obesity and excessive gestational weight gain are associated with components of child cognition. J Nutr 2015; 145: 2562–2569.

    Article  CAS  Google Scholar 

  41. Torres-Espinola FJ, Berglund SK, Garcia-Valdes LM, Segura MT, Jerez A, Campos D 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.

    Article  Google Scholar 

  42. Bayley N . Bayley Scales of Infant Development. Psychological Corporation: San Antonio TX, 1969.

    Google Scholar 

  43. Bayley N . Bayley Scales of Infant Development 2nd edn Psychological Corporation: San Antonio TX, USA, 1993.

    Google Scholar 

  44. Bayley N . Bayley Scales of Infant and Toddler Development 3rd edn Psychological Corporation: San Antonio TX, USA, 2005.

    Google Scholar 

  45. Mehta SH, Kerver JM, Sokol RJ, Keating DP, Paneth N . The association between maternal obesity and neurodevelopmental outcomes of offspring. J Pediatr 2014; 165: 891–896.

    Article  Google Scholar 

  46. Chu SY, Callaghan WM, Kim SY, Schmid CH, Lau J, England LJ et al. Maternal obesity and risk of gestational diabetes mellitus. Diabetes Care 2007; 30: 2070–2076.

    Article  Google Scholar 

  47. Salihu HM, De La Cruz C, Rahman S, August EM . Does maternal obesity cause preeclampsia? A systematic review of the evidence. Minerva Ginecol 2012; 64: 259–280.

    CAS  PubMed  Google Scholar 

  48. Huda SS, Brodie LE, Sattar N . Obesity in pregnancy: prevalence and metabolic consequences. Semin Fetal Neonatal Med 2010; 15: 70–76.

    Article  Google Scholar 

  49. Tozuka Y, Kumon M, Wada E, Onodera M, Mochizuki H, Wada K . Maternal obesity impairs hippocampal BDNF production and spatial learning performance in young mouse offspring. Neurochem Int 2010; 57: 235–247.

    Article  CAS  Google Scholar 

  50. Romero-Corral A, Somers VK, Sierra-Johnson J, Thomas RJ, Collazo-Clavell ML, Korinek J et al. Accuracy of body mass index in diagnosing obesity in the adult general population. Int J Obes (Lond) 2008; 32: 959–966.

    Article  CAS  Google Scholar 

  51. Yun S, Zhu BP, Black W, Brownson RC . A comparison of national estimates of obesity prevalence from the behavioral risk factor surveillance system and the National Health and Nutrition Examination Survey. Int J Obes (Lond) 2006; 30: 164–170.

    Article  CAS  Google Scholar 

  52. Russell A, Gillespie S, Satya S, Gaudet LM . Assessing the accuracy of pregnant women in recalling pre-pregnancy weight and gestational weight gain. J Obstet Gynaecol Can 2013; 35: 802–809.

    Article  Google Scholar 

Download references

Acknowledgements

AAA supported by International Postgraduate Research Scholarship (IPRS) and UQ Centennial scholarship. GDM is funded by an Australian Research Council Future Fellowship (FT120100812). We thank Mr Scott Macintyre for his unreserved professional guidance during electronic database searching.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to A A Adane.

Ethics declarations

Competing interests

The authors declare no conflict of interest.

Additional information

Supplementary Information accompanies this paper on International Journal of Obesity website

Supplementary information

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Adane, A., Mishra, G. & Tooth, L. Maternal pre-pregnancy obesity and childhood physical and cognitive development of children: a systematic review. Int J Obes 40, 1608–1618 (2016). https://doi.org/10.1038/ijo.2016.140

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/ijo.2016.140

This article is cited by

Search

Quick links