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Cited by 114Birth, Development, and HealthGestational Diabetes Research and ManagementObesity, Physical Activity, Diet

The Society for Social Medicine John Pemberton Lecture 2011. Developmental overnutrition—an old hypothesis with new importance?*

Lawlor, Debbie A·2013·International Journal of Epidemiology
DOI 10.1093/ije/dys209
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Abstract

This paper is concerned with whether mothers who are more adipose or have higher glucose levels during pregnancy may overfeed their developing infants in utero and in doing so may set them on a pathway to greater adiposity throughout their lives. If this is the case, then the more adipose daughters of these mothers may also subsequently overfeed their infants in utero, thereby perpetuating the risk of greater adiposity across generations. I begin with the historical context of how gestational diabetes was first recognized and early evidence that diabetes in pregnancy results in increased birth size and adiposity. I then consider four questions, which are the main focus of the paper. Each of the four questions involves an exposure during pregnancy and evidence concerned with whether the exposure is causally related to offspring adiposity via intra-uterine mechanisms. The four related exposures are: (i) pregnancy diabetes; (ii) extreme maternal pregnancy obesity (>40 kg/m2 or meeting criteria for bariatric surgery); (iii) incrementally greater pre-/early pregnancy adiposity across the whole distribution seen in pregnant women; and (iv) gestational weight gain. Since randomized controlled trial evidence is not available I focus on methods that can provide the best causal evidence from observational data such as negative control studies, family comparisons and using genetic variants as instrumental variables (i.e. Mendelian randomization studies). Having addressed these four questions I go on to briefly discuss the possible role of epigenetic modification mediating any effects of maternal exposures on offspring outcomes. I conclude with a discussion about the future research and policy implications of evidence to date in this field.

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Crossref · 10.1093/ije/dys209

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  • The developmental overnutrition hypothesis suggests that greater maternal adiposity, and associated greater maternal circulating glucose and other nutrients, overfeed the developing fetus resulting in greater birthweight and adiposity throughout life.

    “The ‘developmental overnutrition hypothesis’ suggests that greater maternal adiposity, and associated greater maternal circulating glucose and other nutrients, overfeed the developing fetus resulting in greater birthweight and adiposity throughout life.23,24”

    From A structured approach to hypotheses involving continuous exposures over the life course (2016) · cites this paper as [24]

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Authors
Lawlor, D. A.
Affiliations
University of Bristol (GB)
Corresponding author
Lawlor, Debbie A
ORCID
Lawlor, Debbie A
Venue
International Journal of Epidemiology
Publisher
Oxford University Press (OUP)
Published
2013-02
Volume
42
Issue
1
Pages
7-29
ISSN
  • 0300-5771 (ISSN-L)
  • 1464-3685
DOI
10.1093/ije/dys209
OpenAlex
W2170381049
Cited by
114
References
125
Citations by year
2026: 1 · 2025: 4 · 2024: 2 · 2023: 8 · 2022: 12 · 2021: 7 · 2020: 8 · 2019: 9 · 2018: 9 · 2017: 20 · 2016: 14 · 2015: 8 · 2014: 7 · 2013: 4 · 2012: 1
FWCI
10.21
Type
journal article
Language
en
Open access
closed
Locations
  • International Journal of Epidemiology (publishedVersion)
  • PubMed (publishedVersion)
  • HighWire Press Open Archive (submittedVersion)
Topics
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Birth, Development, and Health
  • Health Sciences › Medicine › Obstetrics and Gynecology › Gestational Diabetes Research and Management
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
Keywords
maternal obesity, gestational diabetes mellitus, maternal blood glucose, fetal overnutrition, offspring adiposity, gestational weight gain, epigenetic modifications, Mendelian randomization, family comparison
MeSH terms
Child Development, Female, Humans, Infant, Infant, Newborn, Male, Pregnancy, Pregnancy Complications, Prenatal Exposure Delayed Effects, Social Medicine, Societies, Medical, United States, Weight Gain, Diabetes, Gestational, Overnutrition, Fetal Development, Adiposity, Overweight

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