• 1
    Nguyen T, Lau DC. The obesity epidemic and its impact on hypertension. Can J Cardiol. 2012;28:326333.
  • 2
    Instituto Nacional de Salud Pública. Encuesta Nacional de Salud y Nutricion: Resultados Nacionales 2012. 2012. Available at:
  • 3
    Colchero MA, Sosa-Rubi SG. Heterogeneity of income and lifestyle determinants of body weight among adult women in Mexico, 2006. Soc Sci Med. 2012;75:120128.
  • 4
    Flegal KM, Carroll MD, Ogden CL, et al. Prevalence and trends in obesity among US adults, 1999–2008. JAMA. 2010;303:235241.
  • 5
    Correia LL, da Silveira DM, Silva AC, et al. Prevalence and determinants of obesity and overweight among reproductive age women living in the semi-arid region of Brazil [in Portuguese]. Cien Saude Colet. 2011;16:133145.
  • 6
    Seabra G, Padilha Pde C, de Queiroz JA, et al. Pregestational overweight and obesity: prevalence and outcome associated with pregnancy [in Portuguese]. Rev Bras Ginecol Obstet. 2011;33:348353.
  • 7
    Heslehurst N, Rankin J, Wilkinson JR, et al. A nationally representative study of maternal obesity in England, UK: trends in incidence and demographic inequalities in 619 323 births, 1989–2007. Int J Obes (Lond). 2010;34:420428.
  • 8
    Sahu MT, Agarwal A, Das V, et al. Impact of maternal body mass index on obstetric outcome. J Obstet Gynaecol Res. 2007;33:655659.
  • 9
    Leung TY, Leung TN, Sahota DS, et al. Trends in maternal obesity and associated risks of adverse pregnancy outcomes in a population of Chinese women. BJOG. 2008;115:15291537.
  • 10
    Benkeser RM, Biritwum R, Hill AG. Prevalence of overweight and obesity and perception of healthy and desirable body size in urban, Ghanaian women. Ghana Med J. 2012;46:6675.
  • 11
    Zambrano E, Nathanielsz PW. Mechanisms by which maternal obesity programs offspring for obesity: evidence from animal studies. Nutr Rev. 2013;71:present issue.
  • 12
    Gavard JA, Artal R. Effect of exercise on pregnancy outcome. Clin Obstet Gynecol. 2008;51:467480.
  • 13
    Vickers MH, Sloboda DM. Strategies for reversing the effects of metabolic disorders induced as a consequence of developmental programming. Front Physiol. 2012;3:242.
  • 14
    Vickers MH, Gluckman PD, Coveny AH, et al. Neonatal leptin treatment reverses developmental programming. Endocrinology. 2005;146:42114216.
  • 15
    Sen S, Simmons RA. Maternal antioxidant supplementation prevents adiposity in the offspring of Western diet-fed rats. Diabetes. 2010;59:30583065.
  • 16
    Dolinoy DC, Weidman JR, Waterland RA, et al. Maternal genistein alters coat color and protects Avy mouse offspring from obesity by modifying the fetal epigenome. Environ Health Perspect. 2006;114:567572.
  • 17
    Nelson SM, Poston L. Intervention strategies to improve outcome in obese pregnancies: insulin resistance and gestational diabetes. In: Gillman MW , Poston L ed. Maternal Obesity. New York: Cambridge University Press; 2012:179198.
  • 18
    Rasmussen KM, Catalano PM, Yaktine AL. New guidelines for weight gain during pregnancy: what obstetrician/gynecologists should know. Curr Opin Obstet Gynecol. 2009;21:521526.
  • 19
    McCance RA, Widdowson EM. Fat. Pediatr Res. 1977;11:10811083.
  • 20
    Oken E, Gillman MW. Intervention strategies to improve outcome in obese pregnancies: focus on gestational weight gain. In: Gillman MW , Poston L , ed. Maternal Obesity. New York: Cambridge University Press; 2012:151178.
  • 21
    Stern JS, Johnson PR. Spontaneous activity and adipose cellularity in the genetically obese Zucker rat (fafa). Metabolism. 1977;26:371380.
  • 22
    Armitage JA, Khan IY, Taylor PD, et al. Developmental programming of the metabolic syndrome by maternal nutritional imbalance: how strong is the evidence from experimental models in mammals? J Physiol. 2004;561:355377.
  • 23
    Armitage JA, Poston L, Taylor PD. Developmental origins of obesity and the metabolic syndrome: the role of maternal obesity. Front Horm Res. 2008;36:7384.
  • 24
    Armitage JA, Taylor PD, Poston L. Experimental models of developmental programming: consequences of exposure to an energy rich diet during development. J Physiol. 2005;565:38.
  • 25
    Zambrano E, Rodriguez-Gonzalez GL, Guzman C, et al. A maternal low protein diet during pregnancy and lactation in the rat impairs male reproductive development. J Physiol. 2005;563:275284.
  • 26
    Plagemann A, Heidrich I, Gotz F, et al. Obesity and enhanced diabetes and cardiovascular risk in adult rats due to early postnatal overfeeding. Exp Clin Endocrinol. 1992;99:154158.
  • 27
    Zambrano E, Bautista CJ, Deas M, et al. A low maternal protein diet during pregnancy and lactation has sex- and window of exposure-specific effects on offspring growth and food intake, glucose metabolism and serum leptin in the rat. J Physiol. 2006;571:221230.
  • 28
    Zambrano E, Martinez-Samayoa PM, Rodriguez-Gonzalez GL, et al. Dietary intervention prior to pregnancy reverses metabolic programming in male offspring of obese rats. J Physiol. 2010;588:17911799.
  • 29
    Vega C, Reyes-Castro L, Bautista C, et al. Exercise in obese female rats has beneficial effects on maternal and male and female offspring metabolism. Int J Obes. 2013: Aug 16. doi: 10.1038/ijo.2013.150.
  • 30
    Gyllenhammer LE, Vanni AK, Byrd-Williams CE, et al. Objective habitual physical activity and estradiol levels in obese Latina adolescents. J Phys Act Health. 2013;10:727733.
  • 31
    Carter LG, Lewis KN, Wilkerson DC, et al. Perinatal exercise improves glucose homeostasis in adult offspring. Am J Physiol Endocrinol Metab. 2012;303:E1061E1068.
  • 32
    Carter LG, Qi NR, de Cabo R, et al. Maternal exercise improves insulin sensitivity in mature rat offspring. Med Sci Sports Exerc. 2013;45:832840.
  • 33
    Gilbert JS, Banek CT, Bauer AJ, et al. Placental and vascular adaptations to exercise training before and during pregnancy in the rat. Am J Physiol Regul Integr Comp Physiol. 2012;303:R520R526.
  • 34
    Gilbert JS, Banek CT, Bauer AJ, et al. Exercise training attenuates placental ischemia-induced hypertension and angiogenic imbalance in the rat. Hypertension. 2012;60:15451551.
  • 35
    Catalano PM, Farrell K, Thomas A, et al. Perinatal risk factors for childhood obesity and metabolic dysregulation. Am J Clin Nutr. 2009;90:13031313.
  • 36
    Crozier SR, Robinson SM, Godfrey KM, et al. Women's dietary patterns change little from before to during pregnancy. J Nutr. 2009;139:19561963.
  • 37
    Morimoto S, Calzada L, Sosa TC, et al. Emergence of ageing-related changes in insulin secretion by pancreatic islets of male rat offspring of mothers fed a low-protein diet. Br J Nutr. 2011;107:15621565.
  • 38
    Dong M, Zheng Q, Ford SP, et al. Maternal obesity, lipotoxicity and cardiovascular diseases in offspring. J Mol Cell Cardiol. 2012;55:111116.
  • 39
    Huang Y, Zhao JX, Yan X, et al. Maternal obesity enhances collagen accumulation and cross-linking in skeletal muscle of ovine offspring. PLoS ONE. 2012;7:e31691.
  • 40
    Long NM, George LA, Uthlaut AB, et al. Maternal obesity and increased nutrient intake before and during gestation in the ewe results in altered growth, adiposity, and glucose tolerance in adult offspring. J Anim Sci. 2010;88:35463553.
  • 41
    Long NM, Rule DC, Zhu MJ, et al. Maternal obesity upregulates fatty acid and glucose transporters and increases expression of enzymes mediating fatty acid biosynthesis in fetal adipose tissue depots. J Anim Sci. 2012;90:22012210.
  • 42
    Muhlhausler BS, Roberts CT, McFarlane JR, et al. Fetal leptin is a signal of fat mass independent of maternal nutrition in ewes fed at or above maintenance energy requirements. Biol Reprod. 2002;67:493499.
  • 43
    Philp LK, Muhlhausler BS, Janovska A, et al. Maternal overnutrition suppresses the phosphorylation of 5′-AMP-activated protein kinase in liver, but not skeletal muscle, in the fetal and neonatal sheep. Am J Physiol Regul Integr Comp Physiol. 2008;295:R1982R1990.
  • 44
    Rattanatray L, MacLaughlin SM, Kleemann DO, et al. Impact of maternal periconceptional overnutrition on fat mass and expression of adipogenic and lipogenic genes in visceral and subcutaneous fat depots in the postnatal lamb. Endocrinology. 2010;151:51955205.
  • 45
    Yan X, Huang Y, Zhao JX, et al. Maternal obesity-impaired insulin signaling in sheep and induced lipid accumulation and fibrosis in skeletal muscle of offspring. Biol Reprod. 2011;85:172178.
  • 46
    Zhang L, Long NM, Hein SM, et al. Maternal obesity in ewes results in reduced fetal pancreatic beta-cell numbers in late gestation and decreased circulating insulin concentration at term. Domest Anim Endocrinol. 2011;40:3039.
  • 47
    Dalton KJ, Dawes GS, Patrick JE. Diurnal, respiratory, and other rhythms of fetal heart rate in lambs. Am J Obstet Gynecol. 1977;127:414424.
  • 48
    Dawes GS. Breathing before birth in animals and man. An essay in developmental medicine. N Engl J Med. 1974;290:557559.
  • 49
    Dawes GS, Moulden M, Redman CW. The advantages of computerized fetal heart rate analysis. J Perinat Med. 1991;19:3945.
  • 50
    Patrick J. The physiological basis for fetal assessment. Semin Perinatol. 1989;13:403408.
  • 51
    George LA, Uthlaut AB, Long NM, et al. Different levels of overnutrition and weight gain during pregnancy have differential effects on fetal growth and organ development. Reprod Biol Endocrinol. 2010;8:75.
  • 52
    Long NM, Ford SP, Nathanielsz PW. Maternal obesity eliminates the neonatal lamb plasma leptin peak. J Physiol. 2011;589:14551462.
  • 53
    Ford SP, Hess BW, Schwope MM, et al. Maternal undernutrition during early to mid-gestation in the ewe results in altered growth, adiposity, and glucose tolerance in male offspring. J Anim Sci. 2007;85:12851294.
  • 54
    Tuersunjiang N, Odhiambo JF, Long NM, et al. Diet reduction in obese ewes from early gestation prevents glucose-insulin dysregulation and returns fetal adiposity and organ development to control levels [published online ahead of print August 6, 2013]. Am J Physiol Endocrinol Metab. doi: 10.1152/ajpendo.00117.2013.
  • 55
    Guo C, Li C, Myatt L, et al. Sexually dimorphic effects of maternal nutrient reduction on expression of genes regulating cortisol metabolism in fetal baboon adipose and liver tissues. Diabetes. 2012;62:11751185.
  • 56
    Doll R, Peto R, Boreham J, et al. Mortality in relation to smoking: 50 years' observations on male British doctors. BMJ. 2004;328:1519.
  • 57
    Catalano PM, Presley L, Minium J, et al. Fetuses of obese mothers develop insulin resistance in utero. Diabetes Care. 2009;32:10761080.
  • 58
    Rasmussen KM , Yaktine AL , eds. Weight Gain during Pregnancy: Reexamining the Guidelines. Washington, DC: The National Academies Press; 2013.
  • 59
    Gillman MW , Poston L , eds. Maternal Obesity. New York: Cambridge University Press; 2012.