Developmental programming by maternal obesity in 2015: Outcomes, mechanisms, and potential interventions

• Leptin is a potential mediator of cardiovascular programming by maternal obesity.
• Insulin contributes to the development of central control of glucose homeostasis.
• Ghrelin has neurodevelopmental actions in the rodent hypothalamus.
• Maternal obesity affects neural mechanisms of reward, motivation, and learning.
• Dietary, exercise and pharmacological interventions aim to improve maternal metabolic state.

This article is part of a Special Issue “SBN 2014”.Obesity in women of child-bearing age is a growing problem in developed and developing countries. Evidence from human studies indicates that maternal BMI correlates with offspring adiposity from an early age and predisposes to metabolic disease in later life. Thus the early life environment is an attractive target for intervention to improve public health. Animal models have been used to investigate the specific physiological outcomes and mechanisms of developmental programming that result from exposure to maternal obesity in utero. From this research, targeted intervention strategies can be designed. In this review we summarise recent progress in this field, with a focus on cardiometabolic disease and central control of appetite and behaviour. We highlight key factors that may mediate programming by maternal obesity, including leptin, insulin, and ghrelin. Finally, we explore potential lifestyle and pharmacological interventions in humans and the current state of evidence from animal models.