Obesity doesn't always have to be the consequence of a certain lifestyle. Many factors can contribute to excessive weight, one of which is the conditioning that a person receives in their foetal and infantile phase, medically termed the perinatal period. Dr Anish Pillai, Lead Consultant, Neonatology and Paediatrics, Motherhood Hospitals, Kharghar, Navi Mumbai, talked to the Onlymyhealth team about the risk factors present during pregnancy up to the initial years of a baby's life, that can lead to obesity later in life.
Perinatal Risk Factors Of Obesity
"There are many perinatal risk factors that can cause the baby to develop obesity later in life," said Dr Pillai. According to the World Health Organisation, the perinatal period begins after 22 weeks into the pregnancy, to 7 days after the birth of the child.
Dr Pilla listed five major perinatal factors that are commonly implicated when it comes to what causes obesity:
Maternal Obesity
"Pregnancy is a stressful experience for the body. he mother must be at her fittest, preferably even before she gets pregnant," said Dr Pillai. This allows the mother to not just have a healthy pregnancy but also strengthen the health of her child.
Maternal obesity is a risk factor for a child to develop obesity later in life. According to an article by researchers from the Erasmus University Medical Centre, published in the Annals of Nutrition and Metabolism, both pre-pregnancy obesity and excessive weight gain during pregnancy is associated with a 3 times likelihood of childhood obesity.
"That is why it is crucial for mothers to have an extremely healthy diet and balanced diet, and keep her Body Mass Index (BMI) in check," said Dr Pillai.
Gestational or Pre-Gestational Diabetes
"That is why mothers must have an extremely healthy diet and balanced diet, and keep her Body Mass Index (BMI) in check," said Dr Pillai.
A study published in the Journal of Diabetes and Its Complications cited numerous studies to state that 7-6% of pregnancies in the United States are complicated by pregestational and gestational diabetes, one of which is childhood obesity.
Intrauterine Growth Restriction
Another surprising factor is Intrauterine Growth Restriction (IUGR), or foetal growth restriction. "Babies who grow smaller in the uterus, or IUGR babies, tend to have a much higher risk of obesity and diabetes later on," said Dr Pillai.
A study published in the Journal of Medicine and Life stated that 75% of IUGR cases remain undiagnosed until birth. The study also listed the main material risk factors of IUGR babies:
- Extremely low or high maternal weight
- Smoking or using recreational drugs
- Advanced maternal age
- First pregnancy
- History of blood pressure during pregnancy
- Family history of IUGR
- Previous IUGR pregnancy
- History of miscarriage
- Anemia
- Prenatal diabetes
- Autoimmune disorders
- Sexually transmitted diseases
- Infectious diseases like tuberculosis or malaria
- Chronic diseases like pulmonary or heart disease
- Malformations in the reproductive organs
C-section Delivery
"Studies have associated a caesarean delivery with a slightly increased risk of obesity compared to vaginally birth," said Dr Pillai.
In a recent study from 2023 appearing in the journal Nature, Japanese researchers conducted an assessment of the Japanese population. They confirmed that the risk of obesity at 3 years of age is elevated in children born via caesarean section compared to those born vaginally.
Similarly, a separate study conducted by researchers from the Harvard TH Chan School of Public Health in 2020 revealed that women delivered via cesarean section (C-section) exhibited a higher likelihood of obesity and the development of type 2 diabetes.
Formula Feeding
"Babies who are mostly formula-fed just after birth, instead of breastfeeding, tend to have a higher risk of obesity," said Dr Pillai.
A research paper featured in BMC's Nutrition Journal analyzed a cohort of 1093 newborns. The study revealed that infants receiving formula milk tended to be overfed, leading to a loss in their capacity to self-regulate their feeding, which in turn resulted in increased body weight and length during later infancy compared to breastfed infants.
Dr Pillai suggested that exclusively breastfeeding the infant and avoiding force-feeding or overfeeding can help reduce this risk. "When weaning the baby off breast milk and towards solid food, avoid feeding them processed foods or pre-packaged cereals. Focusing on a healthy balanced diet in the first year of their life can reduce the risk of obesity," he recommended.
The journey from birth to adulthood can significantly influence a person's health, especially when it comes to obesity. Dr Pillai concluded that these perinatal factors highlight how sensitively and responsibly a pregnancy should be handled.
To mitigate these risks, mothers need to focus on pre-pregnancy health, reducing the likelihood of obesity. By understanding and addressing these perinatal risk factors, we can take proactive steps to promote healthier lives for our children right from the start.