Diabetes and obesity during pregnancy predisposes children to diabetes, obesity and cardiovascular problems

Spain: A recent study published in Cardiovascular Diabetology highlighted the importance of epigenetic remodelling for the first six months of development. 

Research showed that the children of women who were obese or had diabetes during pregnancy developed certain epigenetic alterations that predisposed them to suffer from diseases such as diabetes, obesity and the cardiovascular problems that result from them. This risk not only exists during childhood and adolescence but is also maintained in later stages of life.

The study was carried out by paediatricians from the Hospital General de Valencia, which belongs to the Centro de Investigación Biomédica en Red (CIBER) on Physiopathology of Obesity and Nutrition (CIBEROBN), the University of Valencia and the INCLIVA Health Research Institute of Valencia, in collaboration with scientists from the Epigenetics and Nanomedicine research group (CINN-CSIC), the University of Oviedo, and the CIBER on Rare Diseases (CIBERER).

According to Empar Lurbe, Principal Investigator of the CIBEROBN Group: "Pregnancy is a fundamental period in the life of human beings that actively affects the development of offspring and their predisposition to the future appearance of cardiometabolic diseases. Disorders such as maternal obesity and gestational diabetes can condition the health of the offspring, from infancy to adulthood, increasing the risk of comorbidities that reduce the quality of life and life expectancy".

On the other hand, and in the opinion of Mario Fraga of CIBERER, another of the study's coordinators, "maternal obesity during pregnancy can affect up to 30% of pregnant women, with the resulting repercussions for health systems and their public health policies. However, beyond the epidemiological evidence, the molecular causes responsible for these negative effects on the health of the offspring are unknown".

The study published in the scientific journal 'Cardiovascular Diabetology' describes epigenetic alterations in the offspring beyond birth, associated with the maternal metabolic condition during gestation. These chemical modifications influence gene regulation, and their alteration is behind the development of multiple diseases of great social impact, such as obesity.

To reach these conclusions, an analysis was performed in a pediatric cohort of children born to mothers with obesity or obesity with gestational diabetes. One of the greatest strengths of the study is the longitudinal follow-up, which has been carried out throughout the first year of life in the Pediatrics Department of the Hospital General de Valencia, and which has made it possible to clarify the molecular traces by which mothers can influence the genome of their offspring continuously over time.

The researchers explain how this study represents a new example of how the environment interacts with our genes. In this case, the results indicate that the pregnant mother's health status and metabolic condition can persistently condition the health status of the offspring, which may have important implications for public health issues.

This work constitutes the first evidence that the intrauterine environment and, more specifically, obesity and gestational diabetes can persistently reprogram the methylation patterns of offspring beyond birth.

The alterations involve genes that are part of regulatory pathways of fatty acid metabolism, cardiovascular signalling or mitochondrial bioenergetics, crucial processes in obesity and diabetes mellitus. Detecting these alterations in peripheral blood reinforces the idea that maternal metabolism has systemic effects on child development. 

Reference:

Alba-Linares, J.J., Pérez, R.F., Tejedor, J.R. et al. Maternal obesity and gestational diabetes reprogram the methylome of offspring beyond birth by inducing epigenetic signatures in metabolic and developmental pathways. Cardiovasc Diabetol 22, 44 (2023). https://doi.org/10.1186/s12933-023-01774-y.