Maternal obesity activates a cascade of biological mechanisms that program offspring for lifelong metabolic dysfunction through epigenetic modifications, chronic inflammation, and altered placental function. The review identifies DNA methylation patterns, histone modifications, and microRNA expression as key drivers of fetal programming, while maternal gut dysbiosis compounds these effects through breast milk microbiome alterations.
This comprehensive analysis illuminates how gestational obesity creates an intergenerational transmission system for metabolic disease that extends far beyond simple genetic inheritance. The mechanistic clarity is particularly valuable given rising global obesity rates among women of reproductive age. Unlike previous research focusing on immediate pregnancy complications, this work maps the molecular pathways linking maternal metabolic state to offspring neurodevelopment, cardiovascular risk, and obesity susceptibility across decades. The epigenetic component is especially significant because these modifications are potentially reversible through targeted interventions. However, the narrative review format limits quantitative assessment of effect sizes across different mechanisms. The findings strongly support preconception metabolic optimization as a population health strategy, suggesting that maternal health interventions could break intergenerational cycles of chronic disease more effectively than treating offspring after birth.