Maternal obesity is inseparably connected to adverse health results for the mother and her child. The peripartum period is a critical period of risk. Concentrating on pregnancy is a strategy to impact maternal, fetal, and newborn child wellbeing during pregnancy and beyond. 

Maternal weight and epigenetic impacts, even from an earlier age, give a chance for the child. Examining the significance of maternal pre-pregnancy weight status, gestational weight gain, breastfeeding and postpartum weight reduction in relation to subsequent danger for maternal obesity and obesity in the child is important. 

Advancing ideal maternal weight during the previously established inclination, pregnancy and post partum periods will give long lasting advantages to maternal health and the health of her offspring. 

Dramatic changes in the public eye in the course of recent years have prompted a scourge of obesity that compromises the general wellbeing. In view of the most recent studies, ladies of childbearing age (20-39 years of age) were 32% obese with an extra 24% who were overweight. Organizing ideal weight gain during the first pregnancy and come back to pre-pregnancy weight a while later can possibly diminish the pattern of expanding obesity rates in ladies and their descendants. Regarding equality, single time mothers will in general put on more weight during pregnancy and have higher paces of postpartum weight maintenance than multiple birth ladies. 

Ongoing link of obesity between the mother and child 

After the pregnancy, moms keep on impacting their newborn children's weight gain and weight status.

Breastfeeding is one factor that advances ideal weight gain in infants.

Risk decrease is identified with exclusive breastfeeding and duration of breastfeeding. The one postulated mechanism is the promotion of self-regulation of appetite in the infant. Another significant factor is the introduction of formula foods to the child. Newborn children who get first infant foods later, after 6 months of life, display a lower chance for obesity than the individuals who get infant foods from the early months of life.

Also, family food and activity environment are significant indicators of early weight gain. Weight gain in the earliest stages is a significant hazard for later obesity. In 2011 – 2012, an expected 8.1% of newborn children below 2 years of age were obese. This commonness has not changed over the previous decade. Be that as it may, the obesity rate for 2-to 5-year-old youngsters declined somewhat in the course of the most recent decade from 13.9% to 8.4%.3 During this period, there were significant clinical endeavors and general wellbeing mediations, some of which might be liable for this change. Obstetrics started to follow the 2009 Institute of Medicine Report "Weight Gain during Pregnancy: Reexamining the Guidelines". The USDA Special Supplemental Nutrition Program for Women, Infant, and Children (WIC) changed the food bundles to build fruits and vegetables and to diminish more unhealthy nourishments. Also, pediatrics were progressively guiding families about the dangers of abundance weight gain in the preschool-age children. The decrease in weight among 2 to 5-year-olds is uplifting news. 

For the duration of the existence cycle, there are various times that the risk of obesity in both mother and the progeny are observed. Simultaneously, these times of risk also present an opportunity for intercession and the avoidance of weight. 

Maternal body mass, fetal weight gain and infant birth weight

For the baby, the most grounded indicator of later obesity is maternal pre conceptual BMI.

The mother's pre-conceptual weight status is a marker of both natural and hereditary hazard for the child. Hereditary characteristics from the family can impact obesity risk.

Moderately normal obesity weakness quality variations connect with diet in three potential manners:

1) Increased saturated fat and refined sugar consumption;

2) Decreased energy expenditure

3) Modified lipid digestion regulation.

Almost certainly, hereditary determinants identify with eating behavior. Conditions with promptly accessible calorically-dense foods and different tangible signs to provoke eating are considered especially perilous for those with hereditary risk. Current high obesity rates recommend that such conditions are dangerous for most.

Abundance gestational weight gain is related to risk for both the baby and the mother.

Abundance gestational weight gain is related to fetal macrosomia and expanded hazard for developing childhood obesity. Macrosomic newborn children are at an expanded danger of obesity in adolescence and adulthood contrasted with ordinary birth weight infants. Thus, progressively ideal gestational weight gain diminishes the chance for high birth weight. It is all around reported that numerous ladies increased caloric admission and lessening physical movement during pregnancy. In light of information picked up from sustenance and physical movement mediations advancing conduct change methods, constraining abundance caloric admission and expanding exercise during pregnancy may decrease gestational weight gain. Curbing overabundance gestational weight gain has been related to a lower danger of childhood obesity. This is genuine in any event when first and second-trimester weight gain has surpassed the suggested rules.

Abundance gestational weight gain not just presents wellbeing dangers for the mother during pregnancy, work, and conveyance, yet additionally noteworthy expanded hazard for post pregnancy weight retention.

Furthermore, coming back to pre-pregnancy weight is significant for the mother's wellbeing, yet additionally the strength of her future newborn children. The mother's post-pregnancy weight frequently turns into her pre-pregnancy weight for the following pregnancy. For moms, the hazard for aggravating weight gain and ensuring long haul obesity chance is increased in ladies with short interpregnancy stretches. Ladies who have encountered an interpregnancy increment in BMI might be at higher hazard for gestational diabetes mellitus in the following pregnancy. Studies have demonstrated mellow to direct interpregnancy weight reduction in corpulent moms may diminish the danger of ensuing enormous for-gestational-age babies without essentially expanding the hazard for little for-gestational-age newborn children.

What about low-birth-weight infants?

Low birth weight newborn children, regardless of whether they are before time or tiny for-gestational age, are at expanded hazard for developing obesity to a great extent dependent on quick development during infancy. It has been standard for pediatricians and neonatologists to support fast development for low birth weight babies. Notwithstanding, it is presently comprehended that hazard for obesity is an unintended result of quick early development.

Moreover, low birth weight babies are at expanded hazard for creating metabolic condition, hypertension, higher lipid profiles and cardiovascular diseases in adulthood contrasted with newborn children of typical birth weight.

How does breastfeeding help? 

Breastfeeding has gainful impacts on maternal weight. Postnatal, the mother remains firmly connected to her newborn child through feeding. Breastfeeding offers some assurance for the baby against early rapid weight gain and may elevate come back to pre-pregnancy weight in the mother. Breastfeeding diminishes the chance for later weight in newborn children. In the infant, breastfeeding promotes optimal feeding because infant demand is matched to milk production in the mother. This assists with keeping away from newborn child overfeeding. Formula-fed infants have been appeared to have higher dangers for obesity and type 2 diabetes mellitus. Besides, mom’s impact newborn child weight increases through others taking care of procedures dependent on their insight, convictions and mentalities. A portion of these might be jumbled with the choice to breastfeed. 

Obese women are less inclined to start breastfeeding than their normal weight counterparts. Moreover, they will in general breastfeed for shorter lengths and acquaint strong nourishments with their babies sooner than ordinary weight women.

There are, in this way, added substance dangers identified with maternal obesity and lower probability of breastfeeding. 

General health interventions and implications

Way of life intercessions have included training and conduct advising identified with diet and physical action. Such intercessions have demonstrated positive results in controlling gestational weight gain and gestational diabetes mellitus. Behavioral mediations (counting normal weight checking and social help) are unobtrusively powerful in both forestalling overabundance gestational weight gain and elevating come back to pre-pregnancy weight. Focusing on practice and breastfeeding in the postpartum stage could advance the ideal maternal load with enduring impacts as long as after 10 years.

Ways to avoid obesity in the mother and the child

Obstetrics has the ability to impact maternal weight results during and after pregnancy. These methodologies will hence assist a decline in the risk for the fetus and baby, just as in the mother. Subsequently, these diminished dangers will be striking all through such a person's reality and proceed into the following generations.

The accompanying procedures are prescribed so as to emphatically influence mother-newborn child dyad weight results:

• Counsel and guide ladies during the pre-conception or potentially interpregnancy period about the advantages of beginning pregnancy at the healthiest weight conceivable.
• Provide close observing of gestational weight gain by helping ladies to plot their weights utilizing straightforward, visual, shading coded devices at each pre-birth visit (for instance, a green zone for fitting weight increase, the yellow zone for weight increase moving toward inordinate, red zone for abundance weight gain).
• On the off chance that gestational weight gain surpasses proposals, whenever during the pregnancy, intercede with solid recommendations for conduct and way of life changes (diet, self-observing of weight, work out) to check abundance weight gain.
• Educate patients about the significance of post-pregnancy weight reduction and come back to pre-pregnancy weight for the wellbeing of the mother-newborn child dyad in the following pregnancy.
• During the prenatal and immediate postpartum period, elevate the choice to breastfeed.

 Peri Partum weight impacts current and future pregnancies and the wellbeing of the mother. Education about the significance of ideal instead of unnecessary weight gain for the mother and the newborn child could influence pregnancy and parenting practices. Concentrating on this touchy period is probably going to include a significant bit of the riddle for tackling the obesity epidemic.

Reference:

Christine B. Williams, et al, The Effect of Maternal Obesity on the Offspring, Clin Obstet Gynecol. 2014 Sep; 57(3): 508–515. DOI: 10.1097/GRF.0000000000000043